Factors Associated with Initiation of Chronic Renal Replacement Therapy for Patients with Kidney Failure
Patients with kidney failure sometimes do not receive chronic renal replacement therapy (RRT), even though this may reduce their life expectancy. This study aimed to identify factors associated with initiation of chronic RRT. This cohort study was conducted with Albertans aged >18 years between M...
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| Veröffentlicht in: | Clinical journal of the American Society of Nephrology 2013-08, Vol.8 (8), p.1327-1335 |
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| container_title | Clinical journal of the American Society of Nephrology |
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| creator | Faruque, Labib I Hemmelgarn, Brenda R Wiebe, Natasha Manns, Braden J Ravani, Pietro Klarenbach, Scott Pelletier, Rick Tonelli, Marcello |
| description | Patients with kidney failure sometimes do not receive chronic renal replacement therapy (RRT), even though this may reduce their life expectancy. This study aimed to identify factors associated with initiation of chronic RRT.
This cohort study was conducted with Albertans aged >18 years between May 2002 and March 2009, using linked data from the provincial renal programs, clinical laboratories, and provincial health ministry. This study focused on those who developed kidney failure, defined by an estimated GFR (eGFR) |
| doi_str_mv | 10.2215/CJN.10721012 |
| format | Article |
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This cohort study was conducted with Albertans aged >18 years between May 2002 and March 2009, using linked data from the provincial renal programs, clinical laboratories, and provincial health ministry. This study focused on those who developed kidney failure, defined by an estimated GFR (eGFR) <15 ml/min per 1.73 m(2) at last measurement during follow-up, together with prior CKD (eGFR <60 ml/min per 1.73 m(2) at least 90 days earlier). Multivariable Cox proportional hazards models were used to determine factors significantly associated with initiation of chronic RRT.
In total, 7901 participants had eGFR <15 ml/min per 1.73 m(2) at last measurement. After adjustment, older participants were less likely to initiate chronic RRT. Remote residence location, dementia, and metastatic cancer also decreased the likelihood of initiating RRT. The cumulative probability of initiating RRT during follow-up was 76.8% for urban-dwelling men aged <50 years without comorbidity, but was only 3.2% among remote-dwelling women aged ≥70 years with dementia and metastatic cancer. In contrast, patients with diabetes and heavy/severe proteinuria were more likely to initiate chronic RRT.
There is substantial variability in the likelihood of RRT initiation for patients with eGFR <15 ml/min per 1.73 m(2). Further studies are needed to delineate factors that influence this outcome.</description><identifier>ISSN: 1555-9041</identifier><identifier>EISSN: 1555-905X</identifier><identifier>DOI: 10.2215/CJN.10721012</identifier><identifier>PMID: 23833317</identifier><language>eng</language><publisher>United States: American Society of Nephrology</publisher><subject>Age Factors ; Aged ; Cohort Studies ; Female ; Glomerular Filtration Rate ; Humans ; Kidney Failure, Chronic - mortality ; Kidney Failure, Chronic - physiopathology ; Kidney Failure, Chronic - therapy ; Male ; Middle Aged ; Original ; Renal Replacement Therapy</subject><ispartof>Clinical journal of the American Society of Nephrology, 2013-08, Vol.8 (8), p.1327-1335</ispartof><rights>Copyright © 2013 by the American Society of Nephrology 2013</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c416t-271ed17606d2990e94dd3a8471c0705c5446437d1b7707351c5bc77ae65bc7e93</citedby><cites>FETCH-LOGICAL-c416t-271ed17606d2990e94dd3a8471c0705c5446437d1b7707351c5bc77ae65bc7e93</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://www.ncbi.nlm.nih.gov/pmc/articles/PMC3731909/pdf/$$EPDF$$P50$$Gpubmedcentral$$H</linktopdf><linktohtml>$$Uhttps://www.ncbi.nlm.nih.gov/pmc/articles/PMC3731909/$$EHTML$$P50$$Gpubmedcentral$$H</linktohtml><link.rule.ids>230,314,723,776,780,881,27901,27902,53766,53768</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/23833317$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Faruque, Labib I</creatorcontrib><creatorcontrib>Hemmelgarn, Brenda R</creatorcontrib><creatorcontrib>Wiebe, Natasha</creatorcontrib><creatorcontrib>Manns, Braden J</creatorcontrib><creatorcontrib>Ravani, Pietro</creatorcontrib><creatorcontrib>Klarenbach, Scott</creatorcontrib><creatorcontrib>Pelletier, Rick</creatorcontrib><creatorcontrib>Tonelli, Marcello</creatorcontrib><creatorcontrib>Alberta Kidney Disease Network</creatorcontrib><title>Factors Associated with Initiation of Chronic Renal Replacement Therapy for Patients with Kidney Failure</title><title>Clinical journal of the American Society of Nephrology</title><addtitle>Clin J Am Soc Nephrol</addtitle><description>Patients with kidney failure sometimes do not receive chronic renal replacement therapy (RRT), even though this may reduce their life expectancy. This study aimed to identify factors associated with initiation of chronic RRT.
This cohort study was conducted with Albertans aged >18 years between May 2002 and March 2009, using linked data from the provincial renal programs, clinical laboratories, and provincial health ministry. This study focused on those who developed kidney failure, defined by an estimated GFR (eGFR) <15 ml/min per 1.73 m(2) at last measurement during follow-up, together with prior CKD (eGFR <60 ml/min per 1.73 m(2) at least 90 days earlier). Multivariable Cox proportional hazards models were used to determine factors significantly associated with initiation of chronic RRT.
In total, 7901 participants had eGFR <15 ml/min per 1.73 m(2) at last measurement. After adjustment, older participants were less likely to initiate chronic RRT. Remote residence location, dementia, and metastatic cancer also decreased the likelihood of initiating RRT. The cumulative probability of initiating RRT during follow-up was 76.8% for urban-dwelling men aged <50 years without comorbidity, but was only 3.2% among remote-dwelling women aged ≥70 years with dementia and metastatic cancer. In contrast, patients with diabetes and heavy/severe proteinuria were more likely to initiate chronic RRT.
There is substantial variability in the likelihood of RRT initiation for patients with eGFR <15 ml/min per 1.73 m(2). Further studies are needed to delineate factors that influence this outcome.</description><subject>Age Factors</subject><subject>Aged</subject><subject>Cohort Studies</subject><subject>Female</subject><subject>Glomerular Filtration Rate</subject><subject>Humans</subject><subject>Kidney Failure, Chronic - mortality</subject><subject>Kidney Failure, Chronic - physiopathology</subject><subject>Kidney Failure, Chronic - therapy</subject><subject>Male</subject><subject>Middle Aged</subject><subject>Original</subject><subject>Renal Replacement Therapy</subject><issn>1555-9041</issn><issn>1555-905X</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2013</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><recordid>eNpVkU1vEzEQhi0EoqVw6xn5Vg6k9fhjnb0gVRFpSytAqEi9WY530nXltYO9ocq_x1HaqFzm89E7I72EHAM75RzU2ezb91NgmgMD_oocglJq0jJ193pfSzgg70p5YExKwdVbcsDFVAgB-pD0c-vGlAs9LyU5b0fs6KMfe3oV_VhbnyJNSzrrc4re0V8YbahxFazDAeNIb3vMdrWhy5Tpz8rXWdkpXPsu4obOrQ_rjO_Jm6UNBT885SPye_71dnY5uflxcTU7v5k4Cc044RqwA92wpuNty7CVXSfsVGpwTDPllJSNFLqDhdZMCwVOLZzWFpttxlYckS873dV6MWDn6j_ZBrPKfrB5Y5L15v9N9L25T3-N0AJathX49CSQ0581ltEMvjgMwUZM62JAQiska4Ss6Ocd6nIqJeNyfwaY2Zpjqjnm2ZyKf3z52h5-dqMCJzug9_f9o89oymBDqDg37sGWODVTA4Jr8Q9Ebpiq</recordid><startdate>201308</startdate><enddate>201308</enddate><creator>Faruque, Labib I</creator><creator>Hemmelgarn, Brenda R</creator><creator>Wiebe, Natasha</creator><creator>Manns, Braden J</creator><creator>Ravani, Pietro</creator><creator>Klarenbach, Scott</creator><creator>Pelletier, Rick</creator><creator>Tonelli, Marcello</creator><general>American Society of Nephrology</general><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>7X8</scope><scope>5PM</scope></search><sort><creationdate>201308</creationdate><title>Factors Associated with Initiation of Chronic Renal Replacement Therapy for Patients with Kidney Failure</title><author>Faruque, Labib I ; Hemmelgarn, Brenda R ; Wiebe, Natasha ; Manns, Braden J ; Ravani, Pietro ; Klarenbach, Scott ; Pelletier, Rick ; Tonelli, Marcello</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c416t-271ed17606d2990e94dd3a8471c0705c5446437d1b7707351c5bc77ae65bc7e93</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2013</creationdate><topic>Age Factors</topic><topic>Aged</topic><topic>Cohort Studies</topic><topic>Female</topic><topic>Glomerular Filtration Rate</topic><topic>Humans</topic><topic>Kidney Failure, Chronic - mortality</topic><topic>Kidney Failure, Chronic - physiopathology</topic><topic>Kidney Failure, Chronic - therapy</topic><topic>Male</topic><topic>Middle Aged</topic><topic>Original</topic><topic>Renal Replacement Therapy</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Faruque, Labib I</creatorcontrib><creatorcontrib>Hemmelgarn, Brenda R</creatorcontrib><creatorcontrib>Wiebe, Natasha</creatorcontrib><creatorcontrib>Manns, Braden J</creatorcontrib><creatorcontrib>Ravani, Pietro</creatorcontrib><creatorcontrib>Klarenbach, Scott</creatorcontrib><creatorcontrib>Pelletier, Rick</creatorcontrib><creatorcontrib>Tonelli, Marcello</creatorcontrib><creatorcontrib>Alberta Kidney Disease Network</creatorcontrib><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>MEDLINE - Academic</collection><collection>PubMed Central (Full Participant titles)</collection><jtitle>Clinical journal of the American Society of Nephrology</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Faruque, Labib I</au><au>Hemmelgarn, Brenda R</au><au>Wiebe, Natasha</au><au>Manns, Braden J</au><au>Ravani, Pietro</au><au>Klarenbach, Scott</au><au>Pelletier, Rick</au><au>Tonelli, Marcello</au><aucorp>Alberta Kidney Disease Network</aucorp><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Factors Associated with Initiation of Chronic Renal Replacement Therapy for Patients with Kidney Failure</atitle><jtitle>Clinical journal of the American Society of Nephrology</jtitle><addtitle>Clin J Am Soc Nephrol</addtitle><date>2013-08</date><risdate>2013</risdate><volume>8</volume><issue>8</issue><spage>1327</spage><epage>1335</epage><pages>1327-1335</pages><issn>1555-9041</issn><eissn>1555-905X</eissn><abstract>Patients with kidney failure sometimes do not receive chronic renal replacement therapy (RRT), even though this may reduce their life expectancy. This study aimed to identify factors associated with initiation of chronic RRT.
This cohort study was conducted with Albertans aged >18 years between May 2002 and March 2009, using linked data from the provincial renal programs, clinical laboratories, and provincial health ministry. This study focused on those who developed kidney failure, defined by an estimated GFR (eGFR) <15 ml/min per 1.73 m(2) at last measurement during follow-up, together with prior CKD (eGFR <60 ml/min per 1.73 m(2) at least 90 days earlier). Multivariable Cox proportional hazards models were used to determine factors significantly associated with initiation of chronic RRT.
In total, 7901 participants had eGFR <15 ml/min per 1.73 m(2) at last measurement. After adjustment, older participants were less likely to initiate chronic RRT. Remote residence location, dementia, and metastatic cancer also decreased the likelihood of initiating RRT. The cumulative probability of initiating RRT during follow-up was 76.8% for urban-dwelling men aged <50 years without comorbidity, but was only 3.2% among remote-dwelling women aged ≥70 years with dementia and metastatic cancer. In contrast, patients with diabetes and heavy/severe proteinuria were more likely to initiate chronic RRT.
There is substantial variability in the likelihood of RRT initiation for patients with eGFR <15 ml/min per 1.73 m(2). Further studies are needed to delineate factors that influence this outcome.</abstract><cop>United States</cop><pub>American Society of Nephrology</pub><pmid>23833317</pmid><doi>10.2215/CJN.10721012</doi><tpages>9</tpages><oa>free_for_read</oa></addata></record> |
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| identifier | ISSN: 1555-9041 |
| ispartof | Clinical journal of the American Society of Nephrology, 2013-08, Vol.8 (8), p.1327-1335 |
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| source | MEDLINE; Elektronische Zeitschriftenbibliothek - Frei zugängliche E-Journals; PubMed Central; Alma/SFX Local Collection |
| subjects | Age Factors Aged Cohort Studies Female Glomerular Filtration Rate Humans Kidney Failure, Chronic - mortality Kidney Failure, Chronic - physiopathology Kidney Failure, Chronic - therapy Male Middle Aged Original Renal Replacement Therapy |
| title | Factors Associated with Initiation of Chronic Renal Replacement Therapy for Patients with Kidney Failure |
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