More very elderly in the US going on dialysis

NEW YORK (Reuters Health) - The number of people in their 80s and 90s who need to start dialysis because of kidney failure has increased substantially over the last decade in the US, new research indicates.

Moreover, about half of these patients will die in the year after starting dialysis, a "substantially lower" survival rate than for similarly aged people who do not need dialysis.

The study is the first to examine the epidemiology and outcomes of end-stage renal disease among very elderly patients at the national level, according to the report in the Annals of Internal Medicine.

Dr. Manjula Kurella, from the University of California at San Francisco, and colleagues analyzed data on patients entered in the US Renal Data System.

Between 1996 and 2003, the number of very elderly patients starting dialysis increased from 7054 to 13,577, corresponding to an average yearly increase of nearly 10 percent, the report indicates. After adjusting for population growth, the rate at which octogenarians and nonagenarians began dialysis increased 57 percent during the study period.

Forty-six percent of these elderly patients died within 1 year of initiating dialysis, the investigators note, with the risk being linked to older age, inability to walk, and the number of other medical conditions.

Research should focus on determining the reasons for the increasing incidence of kidney failure in very elderly patients, Kurella's team says. Given the poor outlook and costs of dialysis, they say, "efforts to delay or prevent end-stage renal disease among the very elderly seem warranted."

SOURCE: Annals of Internal Medicine, February 6, 2007.