[Programmed hemodialysis in middle and old age]

Area of Science:

• Nephrology
• Geriatric Medicine
• Internal Medicine

Background:

• Elderly patients present unique challenges for renal replacement therapy.
• Assessing the efficacy and safety of programmed hemodialysis (PH) in senile populations is crucial.

Purpose of the Study:

• To evaluate the outcomes and adaptability of programmed hemodialysis (PH) in patients over 60 years old.
• To determine the validity of using plasma creatinine levels as a primary indicator for initiating PH in senile patients.

Main Methods:

• A retrospective follow-up study of 28 elderly patients (over 60) undergoing PH from 1985 to 1991.
• Analysis of patient survival, treatment duration, pre-treatment laboratory values (urea, creatinine), and incidence of complications.

Main Results:

• Senile patients showed lower pre-treatment urea and creatinine compared to younger individuals, without achieving significant uremia reduction.
• Despite multimorbidity and atherosclerosis, elderly patients adapted successfully to PH, requiring fewer weekly dialysis hours.
• Mortality was observed in 16 out of 28 patients within 60 months; however, manifestations of anemia, hyperparathyroidism, and polyneuropathy were comparable to younger patients.

Conclusions:

• Plasma creatinine is not a reliable determinant for initiating hemodialysis in elderly patients.
• Senile patients can adapt to programmed hemodialysis, often requiring less intensive treatment regimens.
• Further research is needed to optimize hemodialysis protocols for geriatric populations.