Renal failure · 2026
Baseline characteristics and practice patterns in geriatric vs. non-geriatric hemodialysis patients: initial results from a Thai nationwide multicenter prospective cohort (Thai-HDcohort).
СтатьяМногоцентровое исследованиеСравнительное исследованиеНазвание и аннотация: Перевод пока не подготовлен
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Pongsittisak Wanjak, Phannajit Jeerath, Kittanamongkolchai Wonngarm, Tangwonglert Theerasak, Chanchairujira Thawee, Kiattisunthorn Kraiwiporn, Vareesangthip Kornchanok, Surattichaiyakul Bongkod, Nongnuch Arkom, Vongsanim Surachet, Tonsawan Pantipa, Sangthawan Pornpen, Changsirikulchai Siribha, Phutrakool Phanupong, Thanapongsatorn Peerapat, Tantiyavarong Pichaya, Kanjanabuch Talerngsak, Tiranathanagul Khajohn, Sritippayawan Suchai, Yoowannakul Suree, Ophascharoensuk Vuddhidej, Susantitaphong Paweena
Аннотация
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.
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.