title: Is dialysis a viable option for the older patient? Outcomes for patients starting dialysis aged 80 years or older.
abstract: BACKGROUND
  Maximum conservative management (MCM) has been proposed as an alternative care pathway for the increasing number of elderly patients with progressive chronic kidney disease.
  
  
  METHODS
  Retrospective analysis of patients aged ≥80 years of age, starting dialysis between 2000 and 2009 in a centre with an established MCM programme. Demographic data, baseline biochemical markers and survival were collected.
  
  
  RESULTS
  93 consecutive patients were studied; median age 83 years (IQR 81-86). 67 male, 32% diabetic. Median survival 46.5 months (range 0-107), with 1- and 5-year survival 78.5 and 38.3%, respectively. Factors predicting poorer survival were Caucasoid ethnicity (p = 0.04) and serum albumin ≤30 g/l (p = 0.01) at dialysis initiation. Duration of nephrology care prior to dialysis initiation did not effect survival.
  
  
  CONCLUSIONS
  The very elderly electing dialysis were found to have good survival. Further patient characterisation is required to improve decision-making between dialysis and MCM for elderly patients with progressive chronic kidney disease.
authors.affiliation: UCL Centre for Nephrology, Royal Free Hospital, University College London Medical School, London, UK. Anthony.isaacs@nhs.net
authors.forename: Anthony
authors.initials: A
authors.lastname: Isaacs
authors.forename: Aine
authors.initials: A
authors.lastname: Burns
authors.forename: Andrew
authors.initials: A
authors.lastname: Davenport
mesh_terms: D000367:Age Factors; D000369:Aged, 80 and over; D005260:Female; D005919:Glomerular Filtration Rate; D006801:Humans; D007668:Kidney / Q000503:physiopathology; D007676:Kidney Failure, Chronic / Q000097:blood / Q000503:physiopathology / Q000628:therapy*; D008297:Male; D006435:Renal Dialysis; D012189:Retrospective Studies; D012709:Serum Albumin / Q000032:analysis; D016019:Survival Analysis; D016896:Treatment Outcome
chemical_list: D012709:Serum Albumin