Octogenarians Benefit From Nephrology Consult Before Dialysis Start

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In a Swiss study, patients aged 80 years or more were significantly less likely to die if they had a nephrology referral prior to initiating dialysis.
In a Swiss study, patients aged 80 years or more were significantly less likely to die if they had a nephrology referral prior to initiating dialysis.

Prior referral to a nephrologist is associated with better survival among patients who start dialysis when they are aged 80 years or more, according to study findings presented at the European Renal Association-European Dialysis and Transplant Association 55th Congress in Copenhagen, Denmark.

Cyrielle Alves, MD, of the Geneva University Hospitals in Geneva, Switzerland, and colleagues studied 96 patients who started maintenance dialysis at age 80 or above (mean age 83 years). The group included 78 who started hemodialysis and 18 who started peritoneal dialysis. Emergency dialysis was implemented in 44% of patients.

The overall mean survival was 33 months. The 1-year mortality rate was 36.4% in referred patients who had emergency dialysis compared with 11.5% among patients with planned dialysis. The 1-year mean survival time was 334 days among patients with planned dialysis compared with 274 days among those who had emergency dialysis, a significant difference between groups. 

On multivariate analysis, 1-year survival was only associated with prior referral to a nephrologist. Compared with patients who did not have a prior referral to a nephrologist, those who did had a significant 64% decreased risk of death.

Reference

Alves C, Ernandez T, Carballo S, et al. Survival in patients aged above 80 who start dialysis. Presented at the European Renal Association-European Dialysis and Transplant Association 55th Congress in Copenhagen, Denmark. Abstract SP622.

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