title: Very old patients on hemodialysis: how they start and can we predict survival?
abstract: BACKGROUND
  We describe circumstances of dialysis initiation, dialysis prescription and factors affecting survival in elderly patients.
  
  
  METHODS
  We included all incident patients ≥ 80 years old from a National Registry for which clinical and laboratory data at dialysis initiation could retrospectively be obtained.
  
  
  RESULTS
  Of 170 patients included, 24% had diabetes, 30% ischemic heart disease, 13% peripheral arterial disease, 15% active malignancy and 60% prior nephrology care. Mean creatinine was 672 ± 225 µmol/l, eGFR 7.3 ± 3.7 ml/min/1.73 m2, 81% started dialysis in hospital and 78% with a catheter. 32% had < 2 sessions/week and 29% had single-needle dialysis. One-year survival was 74% (median 26 months). In multivariate analysis only age (HR 1.10) and prior nephrology care (HR 0.48) were significant predictors of survival.
  
  
  CONCLUSIONS
  The majority of elderly patients started dialysis with a catheter and in hospital setting. We estimate observed survival as good. Only age and prior nephrology care were independent predictors of survival.
authors.affiliation: Department of Nephrology, University Medical Center Ljubljana, Ljubljana, Slovenia.
authors.forename: Jakob
authors.initials: J
authors.lastname: Gubensek
authors.forename: Rafael
authors.initials: R
authors.lastname: Ponikvar
authors.forename: Robert
authors.initials: R
authors.lastname: Ekart
authors.forename: Jadranka
authors.initials: J
authors.lastname: Buturovic-Ponikvar
mesh_terms: D000367:Age Factors; D000369:Aged, 80 and over; D003404:Creatinine / Q000097:blood; D048909:Diabetes Complications; D003920:Diabetes Mellitus / Q000175:diagnosis* / Q000401:mortality / Q000628:therapy; D005260:Female; D006801:Humans; D007668:Kidney / Q000473:pathology; D007676:Kidney Failure, Chronic / Q000150:complications / Q000175:diagnosis* / Q000401:mortality / Q000628:therapy; D008297:Male; D015999:Multivariate Analysis; D017202:Myocardial Ischemia / Q000150:complications / Q000175:diagnosis* / Q000401:mortality / Q000628:therapy; D009369:Neoplasms / Q000150:complications / Q000175:diagnosis* / Q000401:mortality / Q000628:therapy; D058729:Peripheral Arterial Disease / Q000150:complications / Q000175:diagnosis* / Q000401:mortality / Q000628:therapy; D011379:Prognosis; D012042:Registries; D006435:Renal Dialysis; D012189:Retrospective Studies; D016019:Survival Analysis
chemical_list: D003404:Creatinine