Information from the abstract
Background Older adults represent a rapidly growing segment of the hemodialysis (HD) patient population. However, the specific clinical variations and dialysis management strategies employed for geriatric patients in Thailand remain poorly characterized.Methods We analyzed baseline data from 839 hemodialysis patients enrolled in the Thai-HDcohort, a prospective multicenter study across 13 clinical sites in Thailand. Patients were stratified into a geriatric group (≥ 65 years of age, n = 412) and a younger control cohort (< 65 years of age, n = 427). Demographics, vascular access modalities, baseline laboratory markers, pharmacotherapy, and dialysis prescriptions were compared between the two groups.Results Geriatric patients were more frequently treated in hospital-based facilities (75.0% vs. 67.4%, p = .002). The geriatric group exhibited lower body weight (57.7 vs. 63.0 kg, p < .001) and lower serum albumin (hypoalbuminemia prevalence: 11.6% vs. 5.1%, p = .001). Regarding practice patterns, geriatric patients relied more heavily on tunneled cuffed catheters at enrollment (38.1% vs. 27.7%, p = .005) and were likely to initiate HD using a catheter (41.0% vs. 27.1%, p < .001). Geriatric prescriptions also favored a higher utilization of a 3.0 mmol/L dialysate potassium bath (40.0% vs. 23.7%, p < .001), and a higher dialysate calcium bath of 3.0 mmol/L (19.9% vs. 12.9%, p = .011).Conclusions In this cross-sectional study, geriatric hemodialysis patients showed distinct variations in prescriptions and vascular access. Longitudinal follow- up is essential to determine whether these conservative, individualized strategies improve clinical and survival outcomes.
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Related topics: Dialysis and Renal Disease Management · Central Venous Catheters and Hemodialysis · Parathyroid Disorders and Treatments
Thai researcher and institutional participation
Wanjak Pongsittisak · Jeerath Phannajit · Wonngarm Kittanamongkolchai · Theerasak Tangwonglert · Thawee Chanchairujira · Kraiwiporn Kiattisunthorn · Kornchanok Vareesangthip · Bongkod Surattichaiyakul · Arkom Nongnuch · Surachet Vongsanim · Pantipa Tonsawan · Pornpen Sangthawan · Siribha Changsirikulchai · Phanupong Phutrakool · Peerapat Thanapongsatorn · Pichaya Tantiyavarong · Talerngsak Kanjanabuch · Khajohn Tiranathanagul · Suchai Sritippayawan · Suree Yoowannakul · Vuddhidej Ophascharoensuk · Paweena Susantitaphong · Navamindradhiraj University · Chulalongkorn University · King Chulalongkorn Memorial Hospital · Phramongkutklao Hospital · Siriraj Hospital · Rajamangala Institute of kidney disease · Mahidol University · Ramathibodi Hospital · Chiang Mai University · Khon Kaen University · Prince of Songkla University · Srinakharinwirot University · Thammasat University · Bhumibol Adulyadej Hospital
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