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논문분류	춘계학술대회 초록집
제목	Outcomes of Early Initiation of Dialysis in Elderly Patients with End-stage Renal Disease: A Propensity-matched Analysis of a Prospective Cohort Study
저자	Jae Yoon Park1, Kyung Don Yoo1, Jeonghwan Lee2, Dong Ki Kim1, Kwon Wook Joo1, Shin-Wook Kang3, Chul Woo Yang4, Yong-Lim Kim5, Chun-Soo Lim6, Yon Su Kim1, Jung Pyo Lee6
출판정보	2015; 2015(1):
키워드	고령,투석,말기신부전
초록	Background: The optimal timing for initiating dialysis in end-stage renal disease (ESRD) remains controversial, especially in elderly patients. We therefore investigated the effect of dialysis initiation timing on clinical outcomes in elderly patients with ESRD. Method: A total of 665 patients aged equal or over 65 years who started dialysis from August 2008 to February 2015 were enrolled in Clinical Research Center for End Stage Renal Disease cohort study in Korea. They were divided into 2 groups based on the median estimated glomerular filtration rate, which was 8.85 mL/min/1.73m2. The primary outcome was patient survival and the secondary outcomes were cardiovascular events and Kidney Disease Quality of Life Short Form 36 (KDQOL-36) score. Results: Overall cumulative survival rates were lower in early initiation group (Log-rank p<0.001). However, the survival rates showed no significant difference after matching propensity score. Additionally, early initiation of dialysis was not associated with survival rates after adjustment for age, sex, Charlson comorbidity index, hemoglobin, serum albumin, serum calcium and phosphorus level. Although the early initiation group showed lower physical component summary in KDQOL-36 at 3 months after dialysis, the difference of the scores was not significant at 12 months after dialysis. Conclusion: Early initiation of dialysis was not associated with prognosis in elderly patients with ESRD. The physical functioning was worse for 3 months after dialysis but it became similar to late initiation of dialysis at 1 year after dialysis.
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