Survival of elderly/dialysis patients--a single center study from India

In the absence of national registry and uniformity of treatment, survival of patients on dialysis in our country has been variedly reported. There are no published data on survival of elderly patients (>65 years) on dialysis. Because of several social, economical and practical reasons (mentioned below), not many elderly chronic kidney disease patients opt for dialysis. It is worth while to look into the data of survival of elderly CKD (chronic kidney disease) patients on dialysis to justify the treatment. All CKD patients who continued dialysis for more than 1 month at our center from 1st November 2006 to 31st August 2009 were included in the analysis. Patients who moved to their native place after initiation of dialysis, underwent transplant, discontinued dialysis for personal reasons, or died in the first month were excluded. The survival analysis (Kaplan-Meier) and the demographics were calculated for the elderly group and compared with the young ones (Independent sample T-test). 86 adult patients were included in the retrospective survival analysis, out of which 18 were elderly (21%). Mean age of elderly patients on dialysis was 72.3 +/- 7 years. 77.7 % were males and 77.7 % were diabetics. Median survival of these patients was 25.6 months (SE 10, and 95% CI 5.9 - 45.3) while the younger ones had a median survival of 79.6 months (SE 7.9, 95% CI 64 - 95.3). 24 months survival calculated from KM data set was 41.1% in the elderly whereas it was 96.9% in the young age group. It is conclude that Median survival of elderly dialysis patients is more than 2 years and 2 year survival is more than 40%. Elderly CKD patients, hence, should be encouraged for renal replacement therapy rather than discouraging them with poor survival.