@article{c96892796fe9409696413afcc5cbc028,
title = "Dialysis initiation in older persons across centres and over time in Australia and New Zealand",
abstract = "Aim: With improved life expectancy over time, the burden of kidney failure resulting in kidney replacement therapy (KRT) in older persons is increasing. This study aimed to describe the age distribution at dialysis initiation in Australia and New Zealand (ANZ) across centres and over time. Methods: Adults initiating dialysis as first KRT in ANZ from 1999 to 2018 reported to the Australia and New Zealand Dialysis and Transplant (ANZDATA) Registry were included. The primary outcomes were the age distribution and the proportion of older persons (75 years and older) initiating dialysis across centres and over time. Secondary outcomes were characterization of the older population compared with younger people and differences in dialysis modality and treatment trajectories between groups. Results: Over the study period, 55 382 people initiated dialysis as first KRT, including 10 306 older persons, in 100 centres. Wide variation in age distribution across states/countries was noted, although the proportion of older persons at dialysis initiation did not significantly change over time (from 13% in 1999 to 19% in 2003, then remaining stable thereafter). Older persons were less likely to be treated with home therapies compared with younger people. Older persons were mostly Caucasians; had higher socioeconomic position, more cardiovascular comorbidities and higher eGFR at baseline; and resided in major cities. Higher proportions of older persons per centre were noted in privately funded facilities. Conclusion: Wide variations were noted in the proportions of older persons initiating dialysis across centres and states/country, which were associated with different case-mix across regions, particularly in terms of ethnicity, remoteness and socioeconomic advantage.",
keywords = "dialysis, end-stage kidney disease, Haemodialysis, kidney failure, older persons, peritoneal dialysis",
author = "Isabelle Ethier and Campbell, {Scott B.} and Yeoungjee Cho and Hawley, {Carmel M.} and Isbel, {Nicole M.} and Rathika Krishnasamy and Roberts, {Matthew A.} and David Semple and Matthew Sypek and Viecelli, {Andrea K.} and Johnson, {David W.}",
note = "Funding Information: Y. C. reports personal fees from Baxter, and grant support from Fresenius Medical Care, PKD Australia, NHMRC and Baxter CEC Grant, outside the submitted work. C. H. reports personal fees from Janssen, GlaxoSmithKline and Osuka, and grant support from Baxter, Fresenius, Shire, PKD Aus and NHMRC, outside the submitted work. N. I. reports personal fees from Alexion Pharmaceuticals, outside the submitted work. R. K. reports personal fees from Baxter Healthcare and Amgen and grant support from Baxter, outside the submitted work. D. J. reports personal fees from AWAK, Astra‐Zeneca, Ono, Baxter Healthcare and Fresenius Medical Care, and grant support from Baxter Extramural Grant and Baxter CEC Grant, outside the submitted work. The other authors do not have any interest in the information contained in the manuscript to disclose. This research did not receive any specific grant from funding agencies in the public, commercial, or not‐for‐profit sectors. Funding Information: The authors gratefully acknowledge the contributions of the entire Australia and New Zealand nephrology community (physicians, surgeons, database managers, nurses, renal operators and patients) in providing information for and maintaining the ANZDATA database. Reporting and interpretation of these data should in no way be seen as an official policy or interpretation of the ANZDATA Registry and are the responsibility of the authors. I. E. would like to acknowledge the Centre Hospitalier de l'Universit{\'e} de Montr{\'e}al and the Fondation du CHUM for their support through a fellowship grant. A. V. receives grant support from the Royal Australasian College of Physicians (Jacquot Research Establishment Award) and the Princess Alexandra Research Foundation. D. J. is supported by an Australian National Health and Medical Research Council (NHMRC) Practitioner Fellowship. Y. C. is supported by an Australian NHMRC Early Career Fellowship. Publisher Copyright: {\textcopyright} 2021 Asian Pacific Society of Nephrology.",
year = "2021",
month = jul,
doi = "10.1111/nep.13873",
language = "English",
volume = "26",
pages = "613--622",
journal = "Nephrology",
issn = "1320-5358",
publisher = "Wiley-Blackwell",
number = "7",
}
