Dialysis_in_elderly

Dialysis_in_elderly - Advanced Kidney Disease in Elderly...

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Advanced Kidney Disease in Elderly Anjali Gupta 7/26/11
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Issues Do we change the survival with dialysis ? Identifying subset of elderly who would be good candidates for dialysis. Is there an improvement in quality of life/functional Status? HD vs PD? Timing of access placement?
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Current Facts The average age of the patient undergoing dialysis in the United States and world has been steadily increasingly. More than 25% of all people starting RRT are now 75 years old and above and number is expected to increase. Mortality in the first year after the initiation of dialysis exceeds 35% among those 70 years of age and exceeds 50% among patients older than 80 years.
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Vol 6 July, 2011 CJASN
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Median Survival Europe: 3.3 Yrs ANZ: 1.6 years Japan: 5.4 years North America: 2.5 years
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Elderly with CKD stage V Dialysis or no dialysis?? Dialysis
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What is conservative management? Follow up with multidisciplinary team- nephrologist, dietician and Social worker. Management of anemia Volume control BP control Pain management
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844 patients identified with GFR <15 by review of records over 18 years Co morbidities :DM, PVD, CVA, Cirrhosis, cancer , cardiac Low score <4, high score >4 Nephrol Dial Transplant (2011) 26: 1608–16146 Median survival in RRT as c/w CM was 67.1 vs 21.2 months: P < 0.001
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Results Significant predictors of mortality in RRT gp were age, presence of DM and co morbidity index. Elderly with high co morbidities
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Dialysis_in_elderly - Advanced Kidney Disease in Elderly...

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