[Analyses of factors preventing returning home in elderly patients on dialysis]

A significant number of elderly patients who begin dialysis are not able to return home even after attaining stable dialysis. The aim of the present study is to clarify the factors preventing returning home. Patients aged over 60 years who had newly started dialysis (103 cases) were studied. These were 58 men and 45 women. The age was 73 +/- 7 years (mean +/- standard deviation). In each patient, the cause of renal failure (non-diabetes/diabetes), nutritional state, complications, ambulation, cognitive function, urgency of the initiation into dialysis therapy, occurrence of access failure, presence or absence of the partner, presence or absence of members of the younger generation living in the same house, and the outcome (returning home or prolonged hospitalization) were surveyed. Of the 103 patients, 80 could return home, and 23 could not. First, we investigated the influence of the differences in each factor on the outcome. The subjects were divided into two groups by two categories in each factor. The numbers of patients who could not return home was calculated respectively. Comparisons were carried out by the chi 2 test. Statistically significant factors were ambulation (p < 0.0001), cognitive function (p < 0.0001), and cause of renal failure (p: 0.049). Multivariant logistic regression analysis was also performed using back-ground factors as explanatory variables and the outcome as a dependent variable. The factors presented by the nominal scale were converted to dummy variables. Statistically significant factors were ambulation (p < 0.0001), cognitive function (p: 0.001), and presence or absence of a partner (p: 0.012). Inability to walk, impaired cognitive function, and absence of a partner were the factors preventing returning home.