Nevertheless we have continued to perform annual Al levels on all our dialysis patients. Methods: We retrospectively analysed serum Al from Jan 2010-Dec 2013 using our database (Nephworks 6) as well as RO and water feed levels. Results: 2058 Al tests in 755 patients (62% male, mean age 64 years) were
reviewed showing mean (SD) of 0.41 (0.30) μmol/L. 57 (2.8%) tests from 35 patients had Al levels >1.0 μmol/L and 27 (77%) of these patients were or had been prescribed aluminium hydroxide (AlOH). 7 patients had Al >2.2 μmol/L. In 3 of these patients, no source of Al was identified, at least one patient was dialyzing at home before being transplanted. 182 patients taking AlOH (87% of all patients on AlOH)
had levels ≤ 1.0 μmol/L, but the OR of serum Al >1.0 μmol/L on AlOH selleck chemicals was 9.98. The cost of Deforolimus serum Al assay is $30.60, thus costs were $62,974.80 over the study period or over $1300/month. Despite RO feed water Al levels as high as 48 μmol/L (1300 ng/mL), Al output from the RO was almost always undetectable (<0.1 μmol/L). We have detected dialysate Al levels >2.2 μmo/L only 5 times since 2009, and never in last 3 years. Conclusion: Unselected testing of serum Al appears unnecessary and expensive and we will look to more selective testing of dialysis patients. 236 SURVIVAL TRENDS IN ELDERLY DIALYSIS PATIENTS AND THE GENERAL POPULATION AG RITCHIE1,2, PA CLAYTON2,3 1Concord Hospital, Sydney, NSW; 2Sydney Medical School, Sydney,
NSW; 3ANZDATA Registry, Adelaide, South Australia, Australia Aim: To identify survival trends in elderly dialysis patients compared with the general population. Background: Elderly dialysis patients are the most rapidly growing segment in Australia and survival appears to be improving, but the trends and relationship to general population survival have not been recently assessed. Methods: Observed survival of Australian patients commencing dialysis at 60y or older from 1980–2012 extracted from ANZDATA Registry without censoring for transplantation. Exponential parametric survival analysis used to model dialysis patient survival. Matching age-, sex- and era-specific survival data extracted from the Tolmetin Australian Bureau of Statistics Life Tables. Results: The total number of patients 60y or older commencing dialysis increased from 293 during 1980–82 to 4069 during 2010–2012, and the proportion of patients in this cohort aged 60–64y fell from 60.1 to 21.0%. Over that period the modelled median survival for those commencing dialysis at age 60 improved from 3.5–7.5y (114% increase) in men and women, compared with general population improvements of 17.2–23.3y (35%) in men and 22.0–26.4y (20%) in women. Similar relative survival gains were seen in dialysis cohorts commencing up to 80 years of age however absolute gains were smaller and the life expectancy gap is also increasing.