Supervivencia de pacientes mayores de 75 años en hemodiálisis frente a diálisis peritoneal en una red de clínicas renales en Colombia

Abstract

Introduction: The increase of elderly patients with chronic kidney disease in the recent years has generated the need to study the available therapeutic alternatives for the treatment of this pathology. In the United States, the prevalence of chronic kidney disease in adults older than 75 years increased by 48% and in Colombia by the year 2013, 2,579,739 patients had some precursor disease for the development of CKD according to the high cost account, resulting in a growth of the demand for RRT.

Methods: A historical cohort study was carried out with the objective of estimating the survival of patients within a given dialysis modality between January 1, 2009 and December 31, 2013.

Results: When comparing survival between patients in HD and PD, we showed a lower survival rate for the PD group (HR = 1.18 CI 95% (1,051 - 1,342)) compared with HD, adjusting all the risk factors in the model Cox regression, taking into account that within the risk factors identified with lower survival we found Diabetes (HR = 1.221 95% CI 1.075 - 1.386)), female gender (HR = 1,163 CI 95% (1,027 - 1,318)), age > 85 years (HR = 1.557 95% CI (1.305-1.85)), albumin <2.5 g / dl (HR = 1.295 95% CI (1.126 - 1.49)) and hemoglobin <10 g / dl (HR= 1,248 IC 95% (1,101-1,415)).

Discussion: The survival of patients in PD versus HD is significantly lower for patients in PD as has been seen in other countries for this group of patients. In clinical practice, other factors should be considered to define the best therapy in this age group