An assessment of survival among Korean elderly patients initiating dialysis

A national population-based study

Shina Lee, Jung Hwa Ryu, Hyunwook Kim, Kyoung Hoon Kim, Hyeong Sik Ahn, Hoo Jae Hann, Yongjae Cho, Young Mi Park, Seung Jung Kim, Duk Hee Kang, Kyu Bok Choi, Dong Ryeol Ryu

Research output: Contribution to journalArticle

10 Citations (Scopus)

Abstract

Background: Although the proportion of the elderly patients with incident end-stage renal disease (ESRD) patients has been increasing in Korea, there has been a lack of information on outcomes of dialysis treatment. This study aimed to assess the survival rate and to elucidate predictors for all-cause mortality among elderly Korean patients initiating dialysis. Methods: We analyzed 11,301 patients (6,138 men) aged 65 years or older who had initiated dialysis from 2005 to 2008 and had followed up (median, 37.8 months; range, 3-84 months). Baseline demographics, comorbidities and mortality data were obtained using the database from the Health Insurance Review & Assessment Service. Results: The unadjusted 5-year survival rate was 37.6% for all elderly dialysis patients, and the rate decreased with increasing age categories; 45.9% (65-69), 37.5% (70-74), 28.4% (75-79), 24.1% (80-84), and 13.7% (≥85 years). The multivariate Cox proportional hazard model revealed that age, sex, dialysis modality, the type of insurance, and comorbidities such as diabetes mellitus, myocardial infarction, congestive heart failure, peripheral vascular disease, cerebrovascular disease, dementia, chronic pulmonary disease, hemiparesis, liver disease, and any malignancy were independent predictors for mortality. In addition, survival rate was significantly higher in patients on hemodialysis compared to patients on peritoneal dialysis during the whole follow-up period in the intention-to-treat analysis. Conclusions: Survival rate was significantly associated with age, sex, and various comorbidities in Korean elderly patients initiating dialysis. The results of our study can help to provide relevant guidance on the individualization strategy in elderly ESRD patients requiring dialysis.

Original languageEnglish
Article numbere86776
JournalPLoS One
Volume9
Issue number1
DOIs
Publication statusPublished - 2014 Jan 22

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Dialysis
dialysis
Survival
Population
Survival Rate
survival rate
Comorbidity
kidney diseases
Chronic Kidney Failure
Mortality
Health insurance
Pulmonary diseases
cerebrovascular disorders
health insurance
Cerebrovascular Disorders
vascular diseases
Insurance
Intention to Treat Analysis
hemodialysis
dementia

ASJC Scopus subject areas

  • Biochemistry, Genetics and Molecular Biology(all)
  • Agricultural and Biological Sciences(all)

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An assessment of survival among Korean elderly patients initiating dialysis : A national population-based study. / Lee, Shina; Ryu, Jung Hwa; Kim, Hyunwook; Kim, Kyoung Hoon; Ahn, Hyeong Sik; Hann, Hoo Jae; Cho, Yongjae; Park, Young Mi; Kim, Seung Jung; Kang, Duk Hee; Choi, Kyu Bok; Ryu, Dong Ryeol.

In: PLoS One, Vol. 9, No. 1, e86776, 22.01.2014.

Research output: Contribution to journalArticle

Lee, S, Ryu, JH, Kim, H, Kim, KH, Ahn, HS, Hann, HJ, Cho, Y, Park, YM, Kim, SJ, Kang, DH, Choi, KB & Ryu, DR 2014, 'An assessment of survival among Korean elderly patients initiating dialysis: A national population-based study', PLoS One, vol. 9, no. 1, e86776. https://doi.org/10.1371/journal.pone.0086776
Lee, Shina ; Ryu, Jung Hwa ; Kim, Hyunwook ; Kim, Kyoung Hoon ; Ahn, Hyeong Sik ; Hann, Hoo Jae ; Cho, Yongjae ; Park, Young Mi ; Kim, Seung Jung ; Kang, Duk Hee ; Choi, Kyu Bok ; Ryu, Dong Ryeol. / An assessment of survival among Korean elderly patients initiating dialysis : A national population-based study. In: PLoS One. 2014 ; Vol. 9, No. 1.
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abstract = "Background: Although the proportion of the elderly patients with incident end-stage renal disease (ESRD) patients has been increasing in Korea, there has been a lack of information on outcomes of dialysis treatment. This study aimed to assess the survival rate and to elucidate predictors for all-cause mortality among elderly Korean patients initiating dialysis. Methods: We analyzed 11,301 patients (6,138 men) aged 65 years or older who had initiated dialysis from 2005 to 2008 and had followed up (median, 37.8 months; range, 3-84 months). Baseline demographics, comorbidities and mortality data were obtained using the database from the Health Insurance Review & Assessment Service. Results: The unadjusted 5-year survival rate was 37.6{\%} for all elderly dialysis patients, and the rate decreased with increasing age categories; 45.9{\%} (65-69), 37.5{\%} (70-74), 28.4{\%} (75-79), 24.1{\%} (80-84), and 13.7{\%} (≥85 years). The multivariate Cox proportional hazard model revealed that age, sex, dialysis modality, the type of insurance, and comorbidities such as diabetes mellitus, myocardial infarction, congestive heart failure, peripheral vascular disease, cerebrovascular disease, dementia, chronic pulmonary disease, hemiparesis, liver disease, and any malignancy were independent predictors for mortality. In addition, survival rate was significantly higher in patients on hemodialysis compared to patients on peritoneal dialysis during the whole follow-up period in the intention-to-treat analysis. Conclusions: Survival rate was significantly associated with age, sex, and various comorbidities in Korean elderly patients initiating dialysis. The results of our study can help to provide relevant guidance on the individualization strategy in elderly ESRD patients requiring dialysis.",
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T1 - An assessment of survival among Korean elderly patients initiating dialysis

T2 - A national population-based study

AU - Lee, Shina

AU - Ryu, Jung Hwa

AU - Kim, Hyunwook

AU - Kim, Kyoung Hoon

AU - Ahn, Hyeong Sik

AU - Hann, Hoo Jae

AU - Cho, Yongjae

AU - Park, Young Mi

AU - Kim, Seung Jung

AU - Kang, Duk Hee

AU - Choi, Kyu Bok

AU - Ryu, Dong Ryeol

PY - 2014/1/22

Y1 - 2014/1/22

N2 - Background: Although the proportion of the elderly patients with incident end-stage renal disease (ESRD) patients has been increasing in Korea, there has been a lack of information on outcomes of dialysis treatment. This study aimed to assess the survival rate and to elucidate predictors for all-cause mortality among elderly Korean patients initiating dialysis. Methods: We analyzed 11,301 patients (6,138 men) aged 65 years or older who had initiated dialysis from 2005 to 2008 and had followed up (median, 37.8 months; range, 3-84 months). Baseline demographics, comorbidities and mortality data were obtained using the database from the Health Insurance Review & Assessment Service. Results: The unadjusted 5-year survival rate was 37.6% for all elderly dialysis patients, and the rate decreased with increasing age categories; 45.9% (65-69), 37.5% (70-74), 28.4% (75-79), 24.1% (80-84), and 13.7% (≥85 years). The multivariate Cox proportional hazard model revealed that age, sex, dialysis modality, the type of insurance, and comorbidities such as diabetes mellitus, myocardial infarction, congestive heart failure, peripheral vascular disease, cerebrovascular disease, dementia, chronic pulmonary disease, hemiparesis, liver disease, and any malignancy were independent predictors for mortality. In addition, survival rate was significantly higher in patients on hemodialysis compared to patients on peritoneal dialysis during the whole follow-up period in the intention-to-treat analysis. Conclusions: Survival rate was significantly associated with age, sex, and various comorbidities in Korean elderly patients initiating dialysis. The results of our study can help to provide relevant guidance on the individualization strategy in elderly ESRD patients requiring dialysis.

AB - Background: Although the proportion of the elderly patients with incident end-stage renal disease (ESRD) patients has been increasing in Korea, there has been a lack of information on outcomes of dialysis treatment. This study aimed to assess the survival rate and to elucidate predictors for all-cause mortality among elderly Korean patients initiating dialysis. Methods: We analyzed 11,301 patients (6,138 men) aged 65 years or older who had initiated dialysis from 2005 to 2008 and had followed up (median, 37.8 months; range, 3-84 months). Baseline demographics, comorbidities and mortality data were obtained using the database from the Health Insurance Review & Assessment Service. Results: The unadjusted 5-year survival rate was 37.6% for all elderly dialysis patients, and the rate decreased with increasing age categories; 45.9% (65-69), 37.5% (70-74), 28.4% (75-79), 24.1% (80-84), and 13.7% (≥85 years). The multivariate Cox proportional hazard model revealed that age, sex, dialysis modality, the type of insurance, and comorbidities such as diabetes mellitus, myocardial infarction, congestive heart failure, peripheral vascular disease, cerebrovascular disease, dementia, chronic pulmonary disease, hemiparesis, liver disease, and any malignancy were independent predictors for mortality. In addition, survival rate was significantly higher in patients on hemodialysis compared to patients on peritoneal dialysis during the whole follow-up period in the intention-to-treat analysis. Conclusions: Survival rate was significantly associated with age, sex, and various comorbidities in Korean elderly patients initiating dialysis. The results of our study can help to provide relevant guidance on the individualization strategy in elderly ESRD patients requiring dialysis.

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