Clinical Characteristic Analysis of Elderly Patients Undergoing Hemodialysis_West China Medical Journal

Authors：

 WANGZheng-kang ^1,2 , LIULi ¹ ,  ZHOULi ¹ , ZHUHong-ping ¹ , CUITian-lei ¹

1. Department of Nephrology, West China Hospital, Sichuan University, Chengdu, Sichuan 610041, P. R. China;
2. Department of Nephrology, People's Hospital of Dayi County, Dayi, Sichuan 611300, P. R. China;

Corresponding author：

ZHOULi, Email: zhouli126@hotmail.com

Keywords：

Elderly; Hemodialysis; Complications; Mortality

DOI：

10.7507/1002-0179.20150635

Video：

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Objective To study the clinical characteristics of elderly hemodialysis (HD) patients and discuss how to control their complications, in order to improve their quality of life and lower their mortality rate. Method Contrastive study and analysis were performed on the clinical data of 98 maintenance HD patients (between elderly and young HD patients) between January 2013 and January 2014. Complications, rate of hospitalization and mortality were analyzed during the follow-up of one year. Results The ratio of hypertensive kidney disease and diabetic nephropathy, as primary disease of the elderly HD patients, gradually increased. More people chose to use semi-permanent jugular vein catheter for elderly HD patients. Compared with young HD patients, the levels of hemoglobin, albumin, serum creatinine, KT/v were lower in the elderly patients, and C-reactive protein was much higher (P<0.05). There was no significant difference in cholesterol, triglyceride, calcium, phosphorus, parathormone between the two groups (P>0.05). Dialysis-related hypotension and blocking of vascular access occurred more frequently in elderly HD patients. Hospitalization rate and mortality rate were higher in elderly HD patients (P<0.05). Conclusions Improving nutritional status, keeping vascular access unobstructed for a long time and decreasing complications related to hemodialysis are helpful for elderly HD patients to enhance their quality of life and reduce the mortality rate.

Citation： WANGZheng-kang, LIULi, ZHOULi, ZHUHong-ping, CUITian-lei. Clinical Characteristic Analysis of Elderly Patients Undergoing Hemodialysis. West China Medical Journal, 2015, 30(12): 2212-2215. doi: 10.7507/1002-0179.20150635 Copy

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2.	Kucirka LM, Grams ME, Lessler J, et al. Association of race and age with survival among patients undergoing dialysis[J]. JAMA, 2011, 306(6):620-626.
3.	叶任高, 沈清瑞. 肾脏病诊断与治疗学[M]. 北京:人民卫生出版社, 1994:628-630.
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6.	李国强, 范吕燕. 本区域60岁以上人群中临床糖尿病肾病发病率的调查分析[J]. 国际检验医学杂志, 2014, 2(2):190-191.
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9.	王会玲, 王文龙, 于秀峙, 等. MIS评分对血透患者营养不良-炎症状态及住院/死亡风险的相关性[J]. 中国中西医结合肾病杂志, 2010, 11(8):695-699.
10.	Kalantar-Zadeh K, Ikizler TA, Block G, et al. Malnutrition-inflammation complex syndrome in dialysis patients:causes and consequences[J]. Am J Kidney Dis, 2003, 42(5):864-881.
11.	张利, 陈香美, 申力军, 等. 老年血液透析患者死亡相关因素分析[J]. 中国老年学杂志, 2005, 25(4):359-361.
12.	Chang MH, Chou KJ. The role of autonomic neuropathy in the genesis of intradialytic hypotension[J]. Am J Nephrol, 2001, 21(5):357-361.
13.	王云. 回顾性分析36例慢性肾衰维持性血液透析患者发生低血压的相关因素[J]. 当代医学, 2011, 6(6):81-82.
14.	苏海燕. 血液透析中低血压对动静脉内瘘闭塞的影响[J]. 中国医药指南, 2011, 9(36):165-166.
15.	张梅, 黄雯, 岳英, 等. 维持性血液透析患者住院原因及相关因素分析[J]. 中国血液净化, 2013, 2(2):82-85.
16.	James MT, Quan H, Tonelli M, et al. CKD and risk of hospitalization and death with pneumonia[J]. Am J Kidney Dis, 2009, 54(1):24-32.
17.	Rayner HC, Pisoni RL, Bommer J, et al. Mortality and hospitalization in haemodialysis patients in five European countries:results from the Dialysis Outcomes and Practice Patterns Study (DOPPS)[J]. Nephrol Dial Transplant, 2004, 19(1):108-120.
18.	Spiegel DM, Raggi P, Smits G, et al. Factors associated with mortality in patients new to haemodialysis[J]. Nephrol Dial Transplant, 2007, 22(12):3568-3572.

1. Collins AJ, Foley RN, Chavers B, et al. United States renal data system 2011 annual Data Report:Atlas of chronic kidney disease & end-stage renal disease in the United States[J]. Am J Kidney Dis, 2012, 59(1 Suppl 1):A7, e1-e420.
2. Kucirka LM, Grams ME, Lessler J, et al. Association of race and age with survival among patients undergoing dialysis[J]. JAMA, 2011, 306(6):620-626.
3. 叶任高, 沈清瑞. 肾脏病诊断与治疗学[M]. 北京:人民卫生出版社, 1994:628-630.
4. 中华医学会肾脏病分会透析移植登记工作组. 1999年度全国透析移植登记报告[J]. 中华肾脏病杂志, 2001, 17(2):77-101.
5. 谢红浪, 刘志红, 季大玺, 等. 糖尿病肾病维持性血液透析长期生存率及其相关因素分析[J]. 肾脏病与透析肾移植杂志, 2008, 17(5):401-407, 414.
6. 李国强, 范吕燕. 本区域60岁以上人群中临床糖尿病肾病发病率的调查分析[J]. 国际检验医学杂志, 2014, 2(2):190-191.
7. 王文龙, 柳茂森, 王会玲, 等. 维持性血液透析患者营养不良-炎症反应状态与其住院及死亡风险的临床研究[J]. 中华肾脏病杂志, 2012, 28(5):382-387.
8. Kotur-Stevuljevic J, Simic-Ogrizovic S, Dopsaj V, et al. A hazardous link between malnutrition, inflammation and oxidative stress in renal patients[J]. Clin Biochem, 2012, 45(15):1202-1205.
9. 王会玲, 王文龙, 于秀峙, 等. MIS评分对血透患者营养不良-炎症状态及住院/死亡风险的相关性[J]. 中国中西医结合肾病杂志, 2010, 11(8):695-699.
10. Kalantar-Zadeh K, Ikizler TA, Block G, et al. Malnutrition-inflammation complex syndrome in dialysis patients:causes and consequences[J]. Am J Kidney Dis, 2003, 42(5):864-881.
11. 张利, 陈香美, 申力军, 等. 老年血液透析患者死亡相关因素分析[J]. 中国老年学杂志, 2005, 25(4):359-361.
12. Chang MH, Chou KJ. The role of autonomic neuropathy in the genesis of intradialytic hypotension[J]. Am J Nephrol, 2001, 21(5):357-361.
13. 王云. 回顾性分析36例慢性肾衰维持性血液透析患者发生低血压的相关因素[J]. 当代医学, 2011, 6(6):81-82.
14. 苏海燕. 血液透析中低血压对动静脉内瘘闭塞的影响[J]. 中国医药指南, 2011, 9(36):165-166.
15. 张梅, 黄雯, 岳英, 等. 维持性血液透析患者住院原因及相关因素分析[J]. 中国血液净化, 2013, 2(2):82-85.
16. James MT, Quan H, Tonelli M, et al. CKD and risk of hospitalization and death with pneumonia[J]. Am J Kidney Dis, 2009, 54(1):24-32.
17. Rayner HC, Pisoni RL, Bommer J, et al. Mortality and hospitalization in haemodialysis patients in five European countries:results from the Dialysis Outcomes and Practice Patterns Study (DOPPS)[J]. Nephrol Dial Transplant, 2004, 19(1):108-120.
18. Spiegel DM, Raggi P, Smits G, et al. Factors associated with mortality in patients new to haemodialysis[J]. Nephrol Dial Transplant, 2007, 22(12):3568-3572.

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Clinical Characteristic Analysis of Elderly Patients Undergoing Hemodialysis

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