Análisis de sobrevida en pacientes incidentes de hemodiálisis en Chile, 2013-2019

Background: Renal replacement therapies, especially hemodialysis (HD) in end-stage kidney disease, avoid an inevitable death caused by the disease. However, in elderly patients with multiple comorbidities, this therapy could derive in a comparable survival than conservative management. Considering...

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Autores principales:	Sepúlveda,Rodrigo A., Pavlovic,Andrés, Corsi,Oscar, Jara,Aquiles
Lenguaje:	Spanish / Castilian
Publicado:	Sociedad Médica de Santiago 2020
Materias:	Chile Kidney Failure, Chronic Mortality Survival Renal Dialysis
Acceso en línea:	http://www.scielo.cl/scielo.php?script=sci_arttext&pid=S0034-98872020001201715
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spelling	oai:scielo:S0034-988720200012017152021-04-04Análisis de sobrevida en pacientes incidentes de hemodiálisis en Chile, 2013-2019Sepúlveda,Rodrigo A.Pavlovic,AndrésCorsi,OscarJara,Aquiles Chile Kidney Failure, Chronic Mortality Survival Renal Dialysis Background: Renal replacement therapies, especially hemodialysis (HD) in end-stage kidney disease, avoid an inevitable death caused by the disease. However, in elderly patients with multiple comorbidities, this therapy could derive in a comparable survival than conservative management. Considering that HD represents a high cost for the health system, it is worth analyzing the effects of HD on survival. Aim: To analyze the survival and mortality of all national health security system's patients (FONASA) admitted to HD in Chile from 2013 to 2019. Material and Methods: We requested to the Ministry of Health information about all patients affiliated to the public health insurance system that started dialysis between 2013 and 2019. We evaluated the influence of age when starting HD, sex, presence of hypertension, presence of diabetes mellitus (DM), the region of residence, and year of admission on mortality. Results: A total of 24,113 patients aged 61 ± 15 years (45% women) were analyzed. Forty five percent of patients were aged > 65 years. After 5 years of follow-up, the median survival in this age group was 36.1 months. Among patients who started HD at age > 85 years, the median survival was 14.8 months. Diabetic patients had a median survival of 52.3 months. Advanced age and DM were associated with higher annual mortality. Also, the region of residence and year of admission were associated with higher mortality at 3 and 12 months. Conclusions: The median survival of patients on HD is dependent on age and the presence of comorbidities, among other factors. We performed an analysis to determine if starting HD in older patients with comorbidities has a real benefit over conservative management in terms of survival.info:eu-repo/semantics/openAccessSociedad Médica de SantiagoRevista médica de Chile v.148 n.12 20202020-12-01text/htmlhttp://www.scielo.cl/scielo.php?script=sci_arttext&pid=S0034-98872020001201715es10.4067/S0034-98872020001201715
institution	Scielo Chile
collection	Scielo Chile
language	Spanish / Castilian
topic	Chile Kidney Failure, Chronic Mortality Survival Renal Dialysis
spellingShingle	Chile Kidney Failure, Chronic Mortality Survival Renal Dialysis Sepúlveda,Rodrigo A. Pavlovic,Andrés Corsi,Oscar Jara,Aquiles Análisis de sobrevida en pacientes incidentes de hemodiálisis en Chile, 2013-2019
description	Background: Renal replacement therapies, especially hemodialysis (HD) in end-stage kidney disease, avoid an inevitable death caused by the disease. However, in elderly patients with multiple comorbidities, this therapy could derive in a comparable survival than conservative management. Considering that HD represents a high cost for the health system, it is worth analyzing the effects of HD on survival. Aim: To analyze the survival and mortality of all national health security system's patients (FONASA) admitted to HD in Chile from 2013 to 2019. Material and Methods: We requested to the Ministry of Health information about all patients affiliated to the public health insurance system that started dialysis between 2013 and 2019. We evaluated the influence of age when starting HD, sex, presence of hypertension, presence of diabetes mellitus (DM), the region of residence, and year of admission on mortality. Results: A total of 24,113 patients aged 61 ± 15 years (45% women) were analyzed. Forty five percent of patients were aged > 65 years. After 5 years of follow-up, the median survival in this age group was 36.1 months. Among patients who started HD at age > 85 years, the median survival was 14.8 months. Diabetic patients had a median survival of 52.3 months. Advanced age and DM were associated with higher annual mortality. Also, the region of residence and year of admission were associated with higher mortality at 3 and 12 months. Conclusions: The median survival of patients on HD is dependent on age and the presence of comorbidities, among other factors. We performed an analysis to determine if starting HD in older patients with comorbidities has a real benefit over conservative management in terms of survival.
author	Sepúlveda,Rodrigo A. Pavlovic,Andrés Corsi,Oscar Jara,Aquiles
author_facet	Sepúlveda,Rodrigo A. Pavlovic,Andrés Corsi,Oscar Jara,Aquiles
author_sort	Sepúlveda,Rodrigo A.
title	Análisis de sobrevida en pacientes incidentes de hemodiálisis en Chile, 2013-2019
title_short	Análisis de sobrevida en pacientes incidentes de hemodiálisis en Chile, 2013-2019
title_full	Análisis de sobrevida en pacientes incidentes de hemodiálisis en Chile, 2013-2019
title_fullStr	Análisis de sobrevida en pacientes incidentes de hemodiálisis en Chile, 2013-2019
title_full_unstemmed	Análisis de sobrevida en pacientes incidentes de hemodiálisis en Chile, 2013-2019
title_sort	análisis de sobrevida en pacientes incidentes de hemodiálisis en chile, 2013-2019
publisher	Sociedad Médica de Santiago
publishDate	2020
url	http://www.scielo.cl/scielo.php?script=sci_arttext&pid=S0034-98872020001201715
work_keys_str_mv	AT sepulvedarodrigoa analisisdesobrevidaenpacientesincidentesdehemodialisisenchile20132019 AT pavlovicandres analisisdesobrevidaenpacientesincidentesdehemodialisisenchile20132019 AT corsioscar analisisdesobrevidaenpacientesincidentesdehemodialisisenchile20132019 AT jaraaquiles analisisdesobrevidaenpacientesincidentesdehemodialisisenchile20132019
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Análisis de sobrevida en pacientes incidentes de hemodiálisis en Chile, 2013-2019

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