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A large regional hospital's experience with treatment of end-stage renal disease
Insights
Men with end-stage renal disease survived longer than women, with younger transplant recipients showing the highest survival rates. Continuous ambulatory peritoneal dialysis offered a good prognosis for older patients.
Area of Science:
- Nephrology
- Internal Medicine
- Public Health
Background:
- End-stage renal disease (ESRD) affects a significant adult population.
- Treatment options for ESRD include hemodialysis, peritoneal dialysis, and renal transplantation.
- Understanding survival rates and prognostic factors is crucial for managing ESRD patients.
Purpose of the Study:
- To analyze the outcomes of adult patients undergoing treatment for end-stage renal disease.
- To identify factors influencing survival rates in ESRD patients.
- To compare treatment modalities and patient demographics.
Main Methods:
- Life-table analysis was used to assess survival rates.
- Data were collected from 164 adult patients over 10 years.
- Patients were treated with hemodialysis or peritoneal dialysis, with or without renal transplantation.
Main Results:
- Younger renal transplant recipients had the highest survival rates.
- Continuous ambulatory peritoneal dialysis showed a favorable prognosis for older patients.
- Men generally survived longer than women, with survival rates linked to the primary cause of renal disease (e.g., diabetes, systemic disease had worse prognosis).
Conclusions:
- Survival in ESRD patients is influenced by age, treatment modality, and the underlying cause of renal disease.
- Continuous ambulatory peritoneal dialysis is a viable option for older ESRD patients.
- Outcomes at the Saint John Regional Hospital are comparable to major university centers.
Abstract:
During the first 10 years of the treatment program for end-stage renal disease at the Saint John (New Brunswick) Regional Hospital 164 adults were treated by hemodialysis (with or without renal transplantation, performed outside of the province) or peritoneal dialysis. The primary causes of renal disease were not significantly different in men and women except for glomerulonephritis, which was twice as common in men as in women. Life-table analysis showed that the younger transplant recipients had the highest survival rate, but that the prognosis was almost as good among the much older patients who received continuous ambulatory peritoneal dialysis. Probably because they tended to be younger and their renal disease was caused by less threatening conditions, men survived longer than women. The survival rates were significantly related to the primary cause of the renal disease; patients with diabetes or systemic disease had the worst prognosis. Overall, these results compare well with those obtained in major university centres.