Baseline characteristics and practice patterns in geriatric vs. non-geriatric hemodialysis patients: initial results from a Thai nationwide multicenter prospective cohort (Thai-HDcohort)

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.

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Journal
Renal Failure
Published
2026-10-04
DOI
https://doi.org/10.1080/0886022x.2026.2735561
Primary Topic
Dialysis and Renal Disease Management
Type
article
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article

Baseline characteristics and practice patterns in geriatric vs. non-geriatric hemodialysis patients: initial results from a Thai nationwide multicenter prospective cohort (Thai-HDcohort)

Wanjak Pongsittisak, Surachet Vongsanim, Peerapat Thanapongsatorn, Jeerath Phannajit et al.
Renal Failure
Dialysis and Renal Disease Management
article

Baseline characteristics and practice patterns in geriatric vs. non-geriatric hemodialysis patients: initial results from a Thai nationwide multicenter prospective cohort (Thai-HDcohort)

Wanjak Pongsittisak, Surachet Vongsanim, Peerapat Thanapongsatorn, Jeerath Phannajit, Suree Yoowannakul, Khajohn Tiranathanagul, Kraiwiporn Kiattisunthorn, Thawee Chanchairujira, Vuddhidej Ophascharoensuk, Siribha Changsirikulchai, Talerngsak Kanjanabuch, Bongkod Surattichaiyakul, Pichaya Tantiyavarong, Arkom Nongnuch, Pantipa Tonsawan, Wonngarm Kittanamongkolchai, Phanupong Phutrakool, Pornpen Sangthawan, Kornchanok Vareesangthip, Suchai Sritippayawan, Theerasak Tangwonglert, Paweena Susantitaphong
article en

Abstract

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.

Renal FailureVol. 48(1)
Thammasat University (TH), Prince of Songkla University (TH), Siriraj Hospital (TH), Chulalongkorn University (TH), Khon Kaen University (TH), Mahidol University (TH), Navamindradhiraj University (TH), King Chulalongkorn Memorial Hospital (TH), Phramongkutklao Hospital (TH), Rajamangala Institute of kidney disease (TH), Ramathibodi Hospital (TH), Bhumibol Adulyadej Hospital (TH), Chiang Mai University (TH), Srinakharinwirot University (TH)
Openalex Percentile: Top 11%
Dialysis and Renal Disease Management
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