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.	葉任高, 沈清瑞. 腎臟病診斷與治療學[M]. 北京:人民衛生出版社, 1994:628-630.
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5.	謝紅浪, 劉志紅, 季大璽, 等. 糖尿病腎病維持性血液透析長期生存率及其相關因素分析[J]. 腎臟病與透析腎移植雜志, 2008, 17(5):401-407, 414.
6.	李國強, 范呂燕. 本區域60歲以上人群中臨床糖尿病腎病發病率的調查分析[J]. 國際檢驗醫學雜志, 2014, 2(2):190-191.
7.	王文龍, 柳茂森, 王會玲, 等. 維持性血液透析患者營養不良-炎癥反應狀態與其住院及死亡風險的臨床研究[J]. 中華腎臟病雜志, 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.	王會玲, 王文龍, 于秀峙, 等. MIS評分對血透患者營養不良-炎癥狀態及住院/死亡風險的相關性[J]. 中國中西醫結合腎病雜志, 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.	張利, 陳香美, 申力軍, 等. 老年血液透析患者死亡相關因素分析[J]. 中國老年學雜志, 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. 回顧性分析36例慢性腎衰維持性血液透析患者發生低血壓的相關因素[J]. 當代醫學, 2011, 6(6):81-82.
14.	蘇海燕. 血液透析中低血壓對動靜脈內瘺閉塞的影響[J]. 中國醫藥指南, 2011, 9(36):165-166.
15.	張梅, 黃雯, 岳英, 等. 維持性血液透析患者住院原因及相關因素分析[J]. 中國血液凈化, 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. 葉任高, 沈清瑞. 腎臟病診斷與治療學[M]. 北京:人民衛生出版社, 1994:628-630.
4. 中華醫學會腎臟病分會透析移植登記工作組. 1999年度全國透析移植登記報告[J]. 中華腎臟病雜志, 2001, 17(2):77-101.
5. 謝紅浪, 劉志紅, 季大璽, 等. 糖尿病腎病維持性血液透析長期生存率及其相關因素分析[J]. 腎臟病與透析腎移植雜志, 2008, 17(5):401-407, 414.
6. 李國強, 范呂燕. 本區域60歲以上人群中臨床糖尿病腎病發病率的調查分析[J]. 國際檢驗醫學雜志, 2014, 2(2):190-191.
7. 王文龍, 柳茂森, 王會玲, 等. 維持性血液透析患者營養不良-炎癥反應狀態與其住院及死亡風險的臨床研究[J]. 中華腎臟病雜志, 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. 王會玲, 王文龍, 于秀峙, 等. MIS評分對血透患者營養不良-炎癥狀態及住院/死亡風險的相關性[J]. 中國中西醫結合腎病雜志, 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. 張利, 陳香美, 申力軍, 等. 老年血液透析患者死亡相關因素分析[J]. 中國老年學雜志, 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. 回顧性分析36例慢性腎衰維持性血液透析患者發生低血壓的相關因素[J]. 當代醫學, 2011, 6(6):81-82.
14. 蘇海燕. 血液透析中低血壓對動靜脈內瘺閉塞的影響[J]. 中國醫藥指南, 2011, 9(36):165-166.
15. 張梅, 黃雯, 岳英, 等. 維持性血液透析患者住院原因及相關因素分析[J]. 中國血液凈化, 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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West China Medical Journal

Clinical Characteristic Analysis of Elderly Patients Undergoing Hemodialysis

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