Problems in the initial stage of hemodiaiysis in patients over 75 years of age

Abstract

Clinical findings in elderly patients in the initial stage of hemodialysis were evaluated by comparing deceased and surviving groups. It was found that 75% of renal failure was due to chronic glomerulonephritis and/or nephrosclerosis, 10% to diabetic nephropathy. We found that the deceased group had significantly reduced serum total protein (5.77±0.85 vs 6.62±0.63g/dl. p<0.05) and serum albumin (2.79±0.579/dl vs 3.67±0.53, p<0.01), and higher levels of plasma sodium (145.08±6.47mEq/l vs 137.47±6.42, p<0.05) and chloride (110.67±7.90mEq/l vs 101.67±8.57, p<0.05). Five out of six patients in the deceased group showed hypotension during hemodialysis. These findings may suggest that lower colloid oncotic pressure and hypertonic dehydration in the deceased group.
Those in the deceased group had died within 39 days after the introduction of hemodialysis. We conclude that better fluid control in the initial stage of hemodialysis may result in an improved prognosis.