Elderly hemodialysis patients receiving maintenance hemodialysis were studied retrospectively, with special reference to survival rates, morbidity, and response to rehabilitation. The 5-year survival rates were calculated in 43 elderly patients who were 65 years or older at the start of hemodialysis, and compared with those in 171 younger patients who were under 65 years of age at the start of hemodialysis. The cumulative actuarial 5-year survival rate for the elderly patients was 39.8%, significantly lower than the 79.2% for the younger controls (p<0.001). Cardiovascular disease and infection accounted for 41.9% and 23.3% of the deaths in elderly patients similar to findings in younger controls. However, the incidence of death due to cerebral infarction was significantly higher in the elderly (p<0.05). For the elderly in 1991, the hospital days/patient and the frequency of admissions/patient were two and three fold those of younger controls. Admissions due to infection significantly exceeded those in the younger controls. We found that 33 elderly patients with impaired activities of daily living showed a significant improvement in their Barthel index scores after 2.2 months of participation in a rehabilitation program (p<0.001), which was designed to increase their ability to stand and walk unaided. The elderly hemodialysis patients had a higher rate of mortality and morbidity with more frequent, and lengthier hospitalizations than the younger patients because of the prevalence of complications. Despite their lower survival rates, elderly patients receiving hemodialysis can be managed without serious impairment especially if aided by a rehabilitation program.
All Science Journal Classification (ASJC) codes
- Geriatrics and Gerontology