[Epidemiological characteristics of elderly dialysed patients aged 75 and more. Study conducted in the Provence-Alpes-Côte d'Azur region of France]. / Caractéristiques épidémiologiques des personnes dialysées âgées de 75 ans et plus. Etude dans la région Provence-Alpes-Côte d'Azur.

ABSTRACT

INTRODUCTION: One of the consequences of an ageing French population is the large number of elderly patients with end stage renal failure (ESRF). Nephrologists will be increasingly confronted with the growing number of elderly patients and the sometimes-precarious health of the extremely elderly. OBJECTIVE: To describe the epidemiological characteristics of the populations of patients over 75 years in ESRF, treated by dialysis in the Provence Alpes Côte d'Azur region (Paca) in 1999. METHOD: Cross-sectional survey. RESULT: Of the 2347 patients treated by dialysis and resident in the Paca region, 25,1% are aged 75 or more. The prevalence for this age group is of 1428 patients per million persons (pmp) versus 429 pmp for those aged under 75 years. Elderly patients are more frequently treated by dialysis in centres, with shorter dialysis duration. They have more complications related to treatment (perdialytic hypotension, irregular cardiac rhythm), more dependence and more frequently exhibit comorbidity, with the exception of hepatitis C which is less frequent in this population (p<0.0001). The number of patients aged 75 and over treated with dialysis increased 53% between 1995 and 1999 in the Paca region compared with an overall increase of 17% during the same period. The recourse to hemodialysis in a centre for these patients increased by 39.4% whereas it has decreased by 2.4% in younger populations (p<0.0001). In fact, the use of autodialysis has risen enormously +309% for those aged 75 years and more and +88.1% for others. CONCLUSION: The increase in the prevalence of elderly people undergoing dialysis will present problems due to a saturation point which is now being reached in dialysis centres. It is clear that those who forecast health care provisions will need to adapt the supply and demand better to the requirements of the population.