演題情報

Symposium

開催回
第60回・2015年・横浜
 

Poor short-term prognosis in the incident elderly Japanese dialysis patients

演題番号 : GI-10-4-2

Masahiko Yazawa:1、Ryo Kido:2、Seiji Ohira:3、Takeshi Hasegawa:4、Norio Hanafusa:5、Kunitoshi Iseki:6、Yoshiharu Tsubakihara:7、Yugo Shibagaki:1

1:Department of Hypertension and Nephrology, St Marianna University School of Medicine, Japan、2:Inagi Municipal Hospital, Inagi, Tokyo, Japan、3:Sapporo kita clinic, Sapporo, Hokkaido, Japan、4:Center for Innovative Research for Communities and Clinical Excellence, Fukushima Medical University, Fukushima, Japan,The Committee of Renal Data Registry, Japanese Society for Dialysis Therapy, Tokyo, Japan、5:Division of Total Renal Care Medicine, The University of Tokyo Hospital, Tokyo, Japan,The Committee of Renal Data Registry, Japanese Society for Dialysis Therapy, Tokyo, Japan、6:Dialysis Unit, University Hospital of the Ryukyus, Okinawa, Japan,The Committee of Renal Data Registry, Japanese Society for Dialysis Therapy, Tokyo, Japan、7:Department of Comprehensive Kidney Disease Research, Osaka University Graduate School of Medicine, Osaka, Japan,The Committee of Renal Data Registry, Japanese Society for Dialysis Therapy, Tokyo, Japan

 

Mortality in the first few months of starting dialysis has been reported to be high in the Western countries. The few studies addressing this issue have been limited to the Western populations and the elderly ESKD patients, and it is not known this also holds true in Japanese hemodialysis patients who is well known to have much better prognosis. Activity of daily living (ADL) might be recognized as one of the most important prognostic factors, given the dramatic increase in proportion of frail elderly patients after initiation of dialysis. We investigated the relationship between functional status (FS) as ADL levels at initiation of dialysis and incidence of early death after initiation of dialysis in the incident elderly Japanese patients using Japanese national registry data.
Levels of functional disability in ESKD patients were separated into three categories, as follows: Severe (totally bedridden), Moderate (overt difficulties in exerting basic ADL), or Mild/None (no functional disabilities or some functional disabilities). Incidence of early death (death within 3 months) was high among elderly patients those aged 80 or above (15.8%). "Moderate" or "Severe" FS was extremely common (70%) in patients aged ≥80, and early mortality was increasing in those aged ≥80 with impaired FS (4.7%, 14.3%, and 36.5% in those aged ≥80 with “Mild/None”, “Moderate”, and "Severe" FS, respectively.).
Early death in incident dialysis patients was common even in Japanese who have a better long-term prognosis, especially among the elderly. Impaired FS at starting dialysis was significantly associated with incidence of early death.

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