Incidence of end-stage renal disease in the elderly: a steadily rising global socioeconomic epidemic

Paraskevas, Kosmas I.; Bessias, Nikolaos; Koupidis, Sotirios A; Tziviskou, Effie; Mikhailidis, Dimitri P.; Oreopoulos, Dimitrios G.

doi:10.1007/s11255-009-9691-1

Cited by 14 publications

(10 citation statements)

References 21 publications

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“…As a result of the absolute increase of the elderly in the population distribution, the prevalence and incidence of chronic diseases such as hypertension, diabetes mellitus, kidney disease, coronary artery disease, and heart failure have also increased overall. (1–4) The growth in the population of patients with end stage renal disease (ESRD) during the past 20 years has occurred principally in the elderly. (5) The adjusted incidence rate of ESRD for patients who are older than 75 years was 1744 per million population whereas it was only 127 per million population for those between 20 and 44 years old.…”

mentioning

confidence: 99%

Age and the Associations of Living Donor and Expanded Criteria Donor Kidneys With Kidney Transplant Outcomes

Molnar

Streja

Kövesdy

et al. 2012

American Journal of Kidney Diseases

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Background Recent studies show a survival advantage with kidney transplant amongst elderly patients compared to those on dialysis. Study Design In our present study we examined and compared the association of expanded donor criteria (ECD) kidney and living kidney donation with outcome of kidney transplant across different ages including elderly recipients. Setting and Participants Using the Scientific Registry of Transplant Recipients, we identified 145,470 adult kidney transplanted patients. Mortality and death-censored graft failure risks were estimated by Cox proportional regression analyses over a follow-up period with a median of 3.9 years. Predictors ECD kidney and living kidney donation and age compared to others. Outcomes Mortality and death-censored graft failure risk. Results Patients were 45±16 years old and included 40% women and 19% diabetics. Compared to transplanted patients 55-<65 years old, the fully adjusted death-censored graft failure risk was somewhat higher in patients ≥75 years old (HR, 1.30; 95% CI, 1.09–1.56), 35-<55 years (HR, 1.13; 95% CI, 1.08–1.17) and 18-<35 years (HR, 1.64; 95% CI, 1.57–1.71). Compared to non-ECD kidneys, ECD kidneys were significant predictors of mortality in non-elderly patients (18–<35 years: HR, 1.46 [95% CI, 1.19–1.77]; 35-<55 years: HR, 1.23 [95% CI, 1.14–1.32]; and 55-<65 years: HR, 1.26 [95% CI, 1.15–1.38]) and patients aged 65-<70 years (HR, 1.20; 9% CI, 1.05–1.36); but not in other groups of elderly patients (HRs of 1.12 [95% CI, 0.93–1.36] 70-<75 years and 1.04 [95% CI, 0.74–1.47] for ≥75 years). Similar results were found in risk of graft loss. Compared to deceased donor, living kidney was associated with better survival in all age groups and lower graft loss risk in patients aged <70 years. Limitations Unmeasured confounders cannot be adjusted for. Conclusions Among deceased donors, the ECD kidneys are not associated with either increased mortality or graft failure in recipients over 70 years. Among all types of donors, the persistent association between living donor kidneys and lower all-cause mortality across all ages suggests that, if possible, elderly patients gain longevity from living donor kidney transplant.

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confidence: 99%

Age and the Associations of Living Donor and Expanded Criteria Donor Kidneys With Kidney Transplant Outcomes

Molnar

Streja

Kövesdy

et al. 2012

American Journal of Kidney Diseases

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“…One of the authors (DPM) also co-authored two recent editorials that focus on the role of statins in CKD and hypertension [59] and ESKD in the elderly [60]. This material extends the debate regarding the role of statins in CKD and considers the increasing prevalence of ESKD.…”

Section: Expert Opinionmentioning

confidence: 94%

Impact of managing atherogenic dyslipidemia on cardiovascular outcome across different stages of diabetic nephropathy

Athyros

Mitsiou

Τζιόμαλος

et al. 2010

Expert Opinion on Pharmacotherapy

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“…The percentages of patients over the age of 65 years old dialyzing in NKF centers have increased from 16% in 1999 to 22% in 2002 (Tan, Chan, Ho, Wong, Lee, & Woo, 2005). This upward statistics, which was described by Paraskeras, Besslas, Koupidis, Tzivisicov, Milchailidis, and Oreopoulos (2009) to be a "global socioeconomic epidemic, " might be here to stay, given the increasing life Downloaded by [University of Exeter] at 13:08 04 June 2016 expectancy and graying population here and worldwide. Moreover, the Ministry of Health in Singapore estimated in year 2000 that the direct cost of dialysis population and its associated services was in excess of $90 million or over S$36,000 per patient per year (Tan et al, 2005).…”

Section: Introductionmentioning

confidence: 99%

Poor Hemodialysis Outcome Identifying Social Risk Factors in Elderly and Non-elderly Patients in Singapore

Ang

Choo

2011

Asia Pacific Journal of Social Work and Development

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Little is known about the social determinants that predispose hemodialysis patients to poor treatment outcome. Using a clinical data mining method, this study aims to identify differences in social risk factors for hospitalization between elderly and non-elderly patients. The sample consists of 100 elderly and 219 non-elderly patients who started hemodialysis at the National Kidney Foundation from October 2007 to September 2008 and were followed through up to one year of hemodialysis to examine their hospitalization status then. Bivariate analysis revealed differences in the risk profiles between the two groups. The study has implications for funding policy and also draws attention to how clinical interventions ought to be tailored between the two age groups.

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Incidence of end-stage renal disease in the elderly: a steadily rising global socioeconomic epidemic

Cited by 14 publications

References 21 publications

Age and the Associations of Living Donor and Expanded Criteria Donor Kidneys With Kidney Transplant Outcomes

Age and the Associations of Living Donor and Expanded Criteria Donor Kidneys With Kidney Transplant Outcomes

Impact of managing atherogenic dyslipidemia on cardiovascular outcome across different stages of diabetic nephropathy

Poor Hemodialysis Outcome Identifying Social Risk Factors in Elderly and Non-elderly Patients in Singapore

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