Development of a risk stratification algorithm to improve patient-centered care and decision making for incident elderly patients with end-stage renal disease

Kidney International
C CouchoudOlivier P Moranne

Abstract

A significant number of elderly patients die during their first 3 months of dialysis. Because dialysis can impair the quality of both life and death, a personalized care plan based on both early prognosis and patient choices is required. We developed a prognostic screening tool to identify older patients in need of specific care based on a multidisciplinary approach. Our study included 24,348 patients aged 75 years and older from the French national renal epidemiology and information network (REIN) registry who began dialysis between 1 January 2005 and 30 September 2012. Our primary outcome was overall mortality during the first 3 months of renal replacement therapy. Multivariate logistic regression was used to construct a scoring system in a random half of the cohort (training set). This score, which included age, gender, specific comorbidities, albumin levels, and mobility, was then applied to the other half (validation set). In all, 2548 patients died during the first 3 months after dialysis initiation, 22% after dialysis withdrawal. Three risk groups were identified: low risk (score under 12 points, 3-month expected mortality under 20%), intermediate risk (score from 12 to 16, mortality between 20 and 40%, 9.5% of patients)...Continue Reading

References

Feb 1, 1993·Annals of Internal Medicine·J ConcatoT R Holford
Mar 17, 2001·The Journals of Gerontology. Series A, Biological Sciences and Medical Sciences·L P FriedUNKNOWN Cardiovascular Health Study Collaborative Research Group
Apr 24, 2003·JAMA : the Journal of the American Medical Association·Lewis M CohenDavid M Poppel
Jun 28, 2003·American Journal of Kidney Diseases : the Official Journal of the National Kidney Foundation·Brenda R HemmelgarnWilliam A Ghali
Oct 20, 2005·Nephrology, Dialysis, Transplantation : Official Publication of the European Dialysis and Transplant Association - European Renal Association·Cécile CouchoudChristian Jacquelinet
Jul 17, 2007·BMC Medical Research Methodology·Martijn W HeymansHenrica C W de Vet
Nov 20, 2008·BMC Geriatrics·Vincent Mor, Paul R Katz
Dec 20, 2008·Nephrology, Dialysis, Transplantation : Official Publication of the European Dialysis and Transplant Association - European Renal Association·Cécile CouchoudUNKNOWN French Renal Epidemiology and Information Network (REIN) registry
Oct 16, 2009·The New England Journal of Medicine·Manjula Kurella TamuraCharles E McCulloch
Nov 6, 2010·Clinical Journal of the American Society of Nephrology : CJASN·Alvin H Moss
Apr 15, 2011·American Journal of Kidney Diseases : the Official Journal of the National Kidney Foundation·Martin WagnerNavdeep Tangri
May 24, 2011·American Journal of Kidney Diseases : the Official Journal of the National Kidney Foundation·Michael J GermainAlvin H Moss
Jun 29, 2011·Journal of Clinical Oncology : Official Journal of the American Society of Clinical Oncology·Philippe CailletElena Paillaud
Sep 1, 2011·Nature Reviews. Nephrology·Edwina A Brown, Lina Johansson
Oct 1, 2011·Clinical Journal of the American Society of Nephrology : CJASN·Kevin E ChanRaymond M Hakim
Dec 23, 2011·American Journal of Kidney Diseases : the Official Journal of the National Kidney Foundation·C Barrett Bowling, Ann M O'Hare
Jul 4, 2012·QJM : Monthly Journal of the Association of Physicians·G J McMillan, R E Hubbard
Jul 6, 2012·Nephrology, Dialysis, Transplantation : Official Publication of the European Dialysis and Transplant Association - European Renal Association·K J JagerC Wanner
Aug 28, 2012·American Journal of Kidney Diseases : the Official Journal of the National Kidney Foundation·Moniek W M van de LuijtgaardenKitty J Jager
Aug 29, 2012·Journal of Palliative Medicine·Eduardo Bruera, David Hui
Oct 12, 2012·The Journals of Gerontology. Series A, Biological Sciences and Medical Sciences·Olivier MoranneUNKNOWN PSPA Study Investigators
Nov 24, 2012·Seminars in Dialysis·Jocelyn Wiggins, Markus Bitzer
Jun 22, 2013·Nephrology, Dialysis, Transplantation : Official Publication of the European Dialysis and Transplant Association - European Renal Association·Seetha MuthalagappanEdwina A Brown
Jun 27, 2013·Kidney International·Bruce M RobinsonRonald L Pisoni
Jan 18, 2014·American Journal of Kidney Diseases : the Official Journal of the National Kidney Foundation·Tim LuckettJosephine M Clayton
Feb 1, 2014·The Journals of Gerontology. Series A, Biological Sciences and Medical Sciences·Katharine L CheungManjula Kurella Tamura
Jun 3, 2014·Journal of Clinical Medicine Research·Thiago Gomes Romano, Henrique Palomba
Jul 30, 2014·Journal of Clinical Oncology : Official Journal of the American Society of Clinical Oncology·Hans WildiersArti Hurria
Feb 11, 2015·Blood Purification·Michael J Germain
May 6, 2015·Clinical Journal of the American Society of Nephrology : CJASN·Osasuyi Iyasere, Edwina A Brown

❮ Previous
Next ❯

Citations

Jan 26, 2016·Soins. Gérontologie·Isabelle Segalen, Yannick Le Meur
Dec 27, 2015·Journal of Pain and Symptom Management·Stacey CulpAlvin H Moss
Feb 18, 2016·Expert Review of Clinical Pharmacology·Andrea CorsonelloFabrizia Lattanzio
Mar 18, 2016·International Urology and Nephrology·Sabine N van der VeerIonut Nistor
Apr 28, 2016·Clinical Journal of the American Society of Nephrology : CJASN·Ismay N van LoonMarije E Hamaker
Jun 22, 2016·Advances in Chronic Kidney Disease·Jamie A Green, L Ebony Boulware
Jun 28, 2016·Clinical Journal of the American Society of Nephrology : CJASN·Marije H KallenbergSimon P Mooijaart
Aug 12, 2016·Clinical Journal of the American Society of Nephrology : CJASN·Cécile CouchoudSara N Davison
Nov 4, 2016·Nephrology, Dialysis, Transplantation : Official Publication of the European Dialysis and Transplant Association - European Renal Association·Ken FarringtonUNKNOWN ERBP guideline development group
Oct 25, 2016·Kidney International·Edwina A BrownAlan S Kliger
Apr 10, 2017·Nephrology, Dialysis, Transplantation : Official Publication of the European Dialysis and Transplant Association - European Renal Association·Ken FarringtonWim van Biesen
Jan 11, 2018·Current Gerontology and Geriatrics Research·Josefina Santos, Isabel Fonseca
Jan 19, 2018·Nephrology, Dialysis, Transplantation : Official Publication of the European Dialysis and Transplant Association - European Renal Association·Aline C HemkeAndries J Hoitsma
Nov 6, 2018·Nephrology, Dialysis, Transplantation : Official Publication of the European Dialysis and Transplant Association - European Renal Association·Rebecca J SchmidtMichael J Germain
Jul 19, 2017·Clinical Journal of the American Society of Nephrology : CJASN·Ismay N van LoonMarije E Hamaker
Apr 23, 2019·JAMA Internal Medicine·Melissa W WachtermanAmy S Kelley
Feb 21, 2019·Journal of the American Society of Nephrology : JASN·Catherine R ButlerAnn M O'Hare
May 28, 2019·International Urology and Nephrology·Dohui HwangSoon Hyo Kwon
Jun 21, 2017·BMC Nephrology·Steven J RosanskyMatthew McNabney
Oct 2, 2019·JAMA : the Journal of the American Medical Association·Teresa K ChenMorgan E Grams
Mar 13, 2020·Nephrology, Dialysis, Transplantation : Official Publication of the European Dialysis and Transplant Association - European Renal Association·Bernard CanaudFrank Maddux
May 7, 2020·International Urology and Nephrology·Inês DuarteCristina Outerelo
Aug 1, 2019·Clinical Journal of the American Society of Nephrology : CJASN·Ryan T AndersonBjorg Thorsteinsdottir
Jan 29, 2019·Nephrology, Dialysis, Transplantation : Official Publication of the European Dialysis and Transplant Association - European Renal Association·Cédric Villain, Denis Fouque
Sep 9, 2020·Jornal brasileiro de nefrologia : ʹorgão oficial de Sociedades Brasileira e Latino-Americana de Nefrologia·Alze Pereira Dos Santos TavaresJonathan Vinicius Lourenço Souza
Jan 7, 2017·Nephrology, Dialysis, Transplantation : Official Publication of the European Dialysis and Transplant Association - European Renal Association·Cécile CouchoudRené Ecochard
Oct 7, 2017·Current Opinion in Nephrology and Hypertension·Rebecca J Schmidt
Feb 18, 2020·Peritoneal Dialysis International : Journal of the International Society for Peritoneal Dialysis·Edwina A Brown, Helen Hurst
Feb 11, 2019·Peritoneal Dialysis International : Journal of the International Society for Peritoneal Dialysis·Karthik TennankoreUNKNOWN PDOPPS patient support working group
Jan 5, 2021·Journal of Nephrology·Julien ProuvotUNKNOWN PSPA investigators
Dec 6, 2020·American Journal of Kidney Diseases : the Official Journal of the National Kidney Foundation·Louis H DiamondUNKNOWN Steering Committee of the Coalition for Supportive Care of Kidney Patients
Nov 10, 2020·KI Reports·Bernard CanaudPeter Kotanko
Feb 5, 2021·Nephrology, Dialysis, Transplantation : Official Publication of the European Dialysis and Transplant Association - European Renal Association·Jaakko HelvePatrik Finne
Dec 29, 2020·Nephrology, Dialysis, Transplantation : Official Publication of the European Dialysis and Transplant Association - European Renal Association·Marith van Schrojenstein LantmanMiranda van Berkel

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