title: [Description of characteristics, therapy and outcome of patients older than 75 years presenting with severe renal insufficiency (eGFR below 20 mL/min/1.73 m(2): pilot study].
abstract: In France, the incidence of dialysis patients is increasing in people over 75 years and represents 40% of incident patients. In these elderly patients with many comorbidities, the benefit of dialysis in terms of survival and quality of life remains controversial. Using data from REIN, determinants of early mortality were identified and a prognostic score was provided. This approach must now be adapted to elderly with end stage renal failure (ESRF) not on dialysis for which we have little data on their clinical characteristics, therapeutic projects and outcome. We report the results of a pilot study and the prospective study protocol that resulted. In four French nephrology department, 76 patients were studied with a mean age of 83 ± 5 years, with a MDRD estimated GFR (abbreviated MDRD) of 16 ± 4 mL/min/1.73 m(2). These patients were different from the population on dialysis recorded in REIN. This pilot study has shown the feasibility of a prospective study on a larger scale, which aims to build a valuable tool for decision making in elderly patients with ESRF not yet on dialysis.
authors.affiliation: Néphrologie-dialyse-transplantation, hôpital Pasteur, CHU de Nice, 30, voie Romaine, 06002 Nice, France. moranne.o@chu-nice.fr
authors.forename: Olivier
authors.initials: O
authors.lastname: Moranne
authors.forename: Cécile
authors.initials: C
authors.lastname: Couchoud
authors.forename: Anne
authors.initials: A
authors.lastname: Kolko-Labadens
authors.forename: Vincent
authors.initials: V
authors.lastname: Allot
authors.forename: Coraline
authors.initials: C
authors.lastname: Fafin
authors.forename: Cécile
authors.initials: C
authors.lastname: Vigneau
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D003657:Decision Making; D005260:Female; D005500:Follow-Up Studies; D005919:Glomerular Filtration Rate; D006801:Humans; D008297:Male; D010865:Pilot Projects; D051437:Renal Insufficiency / Q000401:mortality* / Q000628:therapy*; D017582:Renal Replacement Therapy / Q000706:statistics & numerical data; D012720:Severity of Illness Index; D016312:Treatment Refusal / Q000706:statistics & numerical data