{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,25]],"date-time":"2026-09-25T18:31:21Z","timestamp":1790361081442,"version":"4.1.0"},"reference-count":30,"publisher":"Wiley","issue":"1","license":[{"start":{"date-parts":[[2018,12,16]],"date-time":"2018-12-16T00:00:00Z","timestamp":1544918400000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Nephrology"],"published-print":{"date-parts":[[2019,1]]},"abstract":"<jats:title>ABSTRACT<\/jats:title><jats:sec><jats:title>Aim<\/jats:title><jats:p>A recent, growing concern regarding haemodialysis in Japan is a sustained increase in the elderly population. Among very elderly people who start haemodialysis, the prognosis is considered to be poor; however, this has not been fully elucidated. This study aimed to discover the short\u2010term prognosis and related factors in very elderly patients who commence haemodialysis.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>Between January 2008 and December 2013, 122 patients aged \u226585 years at haemodialysis initiation were documented in our hospital. Predictors of 90\u2010day and 1\u2010year mortality after haemodialysis initiation were assessed with Cox proportional hazards regression analysis. Selection of covariates for the multivariate model was based on forward stepwise selection using the probability of a likelihood ratio statistics.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>The subjects\u2019 mean age was 87.4 \u00b1 2.5 years, and 48% were female. The most common cause of death was infection (38% of patients) and the leading cause of infectious death was pneumonia. The 90\u2010day and 1\u2010year survival rates were 81% and 62%, respectively. Suboptimal initiation was a significant prognostic factor for 90\u2010day [hazard ratio (HR) 3.98, 95% confidence interval (CI) 1.18\u201313.43] and 1\u2010year [HR 3.19, 95% CI 1.51\u20136.76] mortality after adjusting for confounders in multivariate analysis.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>Very elderly patients who started haemodialysis had a poor prognosis, and suboptimal initiation significantly predicted outcome. Shared decision\u2010making with patients and their families is needed for initiating haemodialysis on the conditions that appropriate information on the expected prognosis is provided.<\/jats:p><\/jats:sec>","DOI":"10.1111\/nep.13194","type":"journal-article","created":{"date-parts":[[2017,11,13]],"date-time":"2017-11-13T13:56:37Z","timestamp":1510581397000},"page":"94-101","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":9,"title":["Suboptimal initiation predicts short\u2010term prognosis and vulnerability among very elderly patients who start haemodialysis"],"prefix":"10.1111","volume":"24","author":[{"given":"Atsuhiro","family":"Kanno","sequence":"first","affiliation":[{"name":"Department of Nephrology Japan Community Health Care Organization (JCHO) Sendai Hospital  Sendai Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Masaaki","family":"Nakayama","sequence":"additional","affiliation":[{"name":"Research Division of Chronic Kidney Disease and Dialysis Treatment Tohoku University Hospital, Tohoku University  Sendai Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Satoru","family":"Sanada","sequence":"additional","affiliation":[{"name":"Department of Nephrology Japan Community Health Care Organization (JCHO) Sendai Hospital  Sendai Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mitsuhiro","family":"Sato","sequence":"additional","affiliation":[{"name":"Department of Nephrology Japan Community Health Care Organization (JCHO) Sendai Hospital  Sendai Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Toshinobu","family":"Sato","sequence":"additional","affiliation":[{"name":"Department of Nephrology Japan Community Health Care Organization (JCHO) Sendai Hospital  Sendai Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yoshio","family":"Taguma","sequence":"additional","affiliation":[{"name":"Department of Nephrology Japan Community Health Care Organization (JCHO) Sendai Hospital  Sendai Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2018,12,16]]},"reference":[{"key":"e_1_2_6_2_1","unstructured":"Cabinet Office.Annual Report on the Aging Society: 2015.2015. 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