Renal and patient outcomes of emergency hemodialysis in elderly individuals: a retrospective cohort study.

IF 1.8 4区 医学 Q3 UROLOGY & NEPHROLOGY
International Urology and Nephrology Pub Date : 2024-12-01 Epub Date: 2024-07-09 DOI:10.1007/s11255-024-04145-y
Zeynep Toker Dincer, Mevlut Tamer Dincer, Serkan Feyyaz Yalin, Sinan Trabulus, Nurhan Seyahi, Mehmet Riza Altiparmak
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Abstract

Purpose: The aging population, commonly defined as individuals aged 65 and above, faces an increased risk of kidney-related diseases. This study investigates emergency dialysis in the elderly population, focusing on indications, clinical and laboratory findings, renal status, and mortality rates.

Methods: The data of 442 elderly patients (≥ 65 years old) who underwent emergency dialysis at a tertiary university hospital were retrospectively examined. Demographics, comorbidities, emergency dialysis indications, clinical presentation, method, complications, pre/post-dialysis status, and follow-up were assessed.

Results: 74.9% of the patients had a history of chronic kidney disease (CKD). Emergency dialysis was mainly initiated due to hypervolemia (43.7%) and uremic symptoms (29.2%). Hypotension was the most common dialysis-related complication (34.4%). The mortality rate was 34.6%; among the survivors, 15.2% achieved complete renal recovery, while 32.5% and 52.3% developed dialysis-independent and -dependent CKD, respectively. In multivariate analysis, blood urea, serum sodium, mean arterial pressure, dyspnea, tachypnea, and tachycardia on admission were found to be associated with mortality.

Conclusion: Our study provides insights into emergency dialysis challenges in the elderly population, emphasizing the need for personalized interventions and further research to improve care and outcomes in this growing demographic.

Abstract Image

老年人紧急血液透析对肾脏和患者的影响:一项回顾性队列研究。
目的:老龄人口(通常指 65 岁及以上人群)罹患肾脏相关疾病的风险增加。本研究调查了老年人群中的紧急透析情况,重点关注适应症、临床和实验室检查结果、肾脏状况和死亡率:方法:回顾性研究了在一家三级大学医院接受紧急透析的 442 名老年患者(≥ 65 岁)的数据。对人口统计学、合并症、紧急透析适应症、临床表现、方法、并发症、透析前后状况和随访情况进行了评估:结果:74.9%的患者有慢性肾脏病(CKD)病史。开始紧急透析的主要原因是高血容量(43.7%)和尿毒症症状(29.2%)。低血压是最常见的透析相关并发症(34.4%)。死亡率为34.6%;在幸存者中,15.2%的人实现了肾功能完全恢复,而32.5%和52.3%的人分别发展为透析非依赖型和依赖型慢性肾脏病。在多变量分析中发现,入院时的血尿素、血清钠、平均动脉压、呼吸困难、呼吸急促和心动过速与死亡率有关:我们的研究为老年人群的紧急透析挑战提供了见解,强调了个性化干预和进一步研究的必要性,以改善这一日益增长的人群的护理和治疗效果。
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来源期刊
International Urology and Nephrology
International Urology and Nephrology 医学-泌尿学与肾脏学
CiteScore
3.40
自引率
5.00%
发文量
329
审稿时长
1.7 months
期刊介绍: International Urology and Nephrology publishes original papers on a broad range of topics in urology, nephrology and andrology. The journal integrates papers originating from clinical practice.
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