Association between dementia diagnosis at dialysis initiation and mortality in older patients with end-stage kidney disease in South Korea
Background: The prevalence of dementia is 2- to 7-fold higher among patients with end-stage kidney disease (ESKD) than among the general population; however, its clinical implications in this population remain unclear. Therefore, this study aimed to determine whether comorbid dementia increases mortality among older patients with ESKD undergoing newly initiated hemodialysis.
Methods: We analyzed data from the Korean Society of Geriatric Nephrology retrospective cohort, which included 2,736 older ESKD patients (≥70 years old) who started hemodialysis between 2010 and 2017. Kaplan-Meier survival and Cox regression analyses were used to examine all-cause mortality between the patients with and without dementia in this cohort.
Results: Of the 2,406 included patients, 8.3% had dementia at the initiation of dialysis; these patients were older (79.6 ± 6.0 years) than patients without dementia (77.7 ± 5.5 years) and included more women (male:female, 89:111). Pre-ESKD diagnosis of dementia was associated with an increased risk of overall mortality (hazard ratio, 1.503; p < 0.001), and this association remained consistent after multivariate adjustment (hazard ratio, 1.268; p = 0.009). In subgroup analysis, prevalent dementia was associated with mortality following dialysis initiation in female patients, those aged <85 years, those with no history of cerebrovascular accidents or severe behavioral disorders, those not residing in nursing facilities, and those with no or short-term hospitalization.
Conclusion: A pre-ESKD diagnosis of dementia is associated with mortality following dialysis initiation in older Korean population. In older patients with ESKD, cognitive assessment at dialysis initiation is necessary.
| Medienart: |
E-Artikel |
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| Erscheinungsjahr: |
2024 |
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| Erschienen: |
2024 |
| Enthalten in: |
Zur Gesamtaufnahme - year:2024 |
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| Enthalten in: |
Kidney research and clinical practice - (2024) vom: 07. Feb. |
| Sprache: |
Englisch |
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| Beteiligte Personen: |
Ye, Byung Min [VerfasserIn] |
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| Links: |
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| Themen: |
Aged |
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| Anmerkungen: |
Date Revised 07.02.2024 published: Print-Electronic Citation Status Publisher |
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| doi: |
10.23876/j.krcp.23.151 |
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| Förderinstitution / Projekttitel: |
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| PPN (Katalog-ID): |
NLM368151085 |
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| 100 | 1 | |a Ye, Byung Min |e verfasserin |4 aut | |
| 245 | 1 | 0 | |a Association between dementia diagnosis at dialysis initiation and mortality in older patients with end-stage kidney disease in South Korea |
| 264 | 1 | |c 2024 | |
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| 500 | |a published: Print-Electronic | ||
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| 520 | |a Background: The prevalence of dementia is 2- to 7-fold higher among patients with end-stage kidney disease (ESKD) than among the general population; however, its clinical implications in this population remain unclear. Therefore, this study aimed to determine whether comorbid dementia increases mortality among older patients with ESKD undergoing newly initiated hemodialysis | ||
| 520 | |a Methods: We analyzed data from the Korean Society of Geriatric Nephrology retrospective cohort, which included 2,736 older ESKD patients (≥70 years old) who started hemodialysis between 2010 and 2017. Kaplan-Meier survival and Cox regression analyses were used to examine all-cause mortality between the patients with and without dementia in this cohort | ||
| 520 | |a Results: Of the 2,406 included patients, 8.3% had dementia at the initiation of dialysis; these patients were older (79.6 ± 6.0 years) than patients without dementia (77.7 ± 5.5 years) and included more women (male:female, 89:111). Pre-ESKD diagnosis of dementia was associated with an increased risk of overall mortality (hazard ratio, 1.503; p < 0.001), and this association remained consistent after multivariate adjustment (hazard ratio, 1.268; p = 0.009). In subgroup analysis, prevalent dementia was associated with mortality following dialysis initiation in female patients, those aged <85 years, those with no history of cerebrovascular accidents or severe behavioral disorders, those not residing in nursing facilities, and those with no or short-term hospitalization | ||
| 520 | |a Conclusion: A pre-ESKD diagnosis of dementia is associated with mortality following dialysis initiation in older Korean population. In older patients with ESKD, cognitive assessment at dialysis initiation is necessary | ||
| 650 | 4 | |a Journal Article | |
| 650 | 4 | |a Aged | |
| 650 | 4 | |a Chronic kidney failure | |
| 650 | 4 | |a Dementia | |
| 650 | 4 | |a Mortality | |
| 650 | 4 | |a Renal dialysis | |
| 700 | 1 | |a Kang, Seongmin |e verfasserin |4 aut | |
| 700 | 1 | |a Park, Woo Yeong |e verfasserin |4 aut | |
| 700 | 1 | |a Cho, Jang-Hee |e verfasserin |4 aut | |
| 700 | 1 | |a Yu, Byung Chul |e verfasserin |4 aut | |
| 700 | 1 | |a Han, Miyeun |e verfasserin |4 aut | |
| 700 | 1 | |a Song, Sang Heon |e verfasserin |4 aut | |
| 700 | 1 | |a Ko, Gang-Jee |e verfasserin |4 aut | |
| 700 | 1 | |a Yang, Jae Won |e verfasserin |4 aut | |
| 700 | 1 | |a Chung, Sungjin |e verfasserin |4 aut | |
| 700 | 1 | |a Hong, Yu Ah |e verfasserin |4 aut | |
| 700 | 1 | |a Hyun, Young Youl |e verfasserin |4 aut | |
| 700 | 1 | |a Bae, Eunjin |e verfasserin |4 aut | |
| 700 | 1 | |a Sun, In O |e verfasserin |4 aut | |
| 700 | 1 | |a Kim, Hyunsuk |e verfasserin |4 aut | |
| 700 | 1 | |a Hwang, Won Min |e verfasserin |4 aut | |
| 700 | 1 | |a Shin, Sung Joon |e verfasserin |4 aut | |
| 700 | 1 | |a Kwon, Soon Hyo |e verfasserin |4 aut | |
| 700 | 1 | |a Kim, Seo Rin |e verfasserin |4 aut | |
| 700 | 1 | |a Yoo, Kyung Don |e verfasserin |4 aut | |
| 700 | 0 | |a Korean Society of Geriatric Nephrology (KSGN) |e verfasserin |4 aut | |
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