INFLUENCE OF COEXISTING DISEASE ON SURVIVAL ON RENAL-REPLACEMENT THERAPY

I H KHAN, G R D CATTO, N EDWARD, L W FLEMING, I S HENDERSON, A M MACLEOD

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Abstract

Survival of patients on renal-replacement therapy (RRT) is no longer improving. Increasingly, such patients are older and have co-morbid conditions affecting organs other than the kidney.

In a retrospective study, we calculated actuarial survival of 375 patients starting RRT during a 6 1/2 year period at renal units in Aberdeen and Dundee, UK, after stratification of patients into three risk groups (low, medium, and high) based predominantly on co-morbidity and to a lesser extent on age. 2-year survival differed significantly between low, medium, and high risk groups both before (86%, 60%, and 35%, respectively; p<0.002 for all comparisons) and after (90%, 70%, 46%; p<0.004 for all comparisons) excluding early deaths (within 90 days of starting RRT). Overall survival was 61% in Aberdeen and 68% in Dundee (p=0.04), but 73% and 74%, respectively, when deaths in the first 90 days were excluded (p=0.73).

We conclude that RRT is a highly successful treatment (86% 2-year survival) for patients aged under 70 with no co-morbid conditions (low-risk group); that coexisting non-renal disease has an important influence on survival of patients on RRT; and that risk stratification and analysis of data including and excluding early deaths should allow more valid comparison of data from different centres.

Original languageEnglish
Pages (from-to)415-418
Number of pages4
JournalThe Lancet
Volume341
Issue number8842
DOIs
Publication statusPublished - 13 Feb 1993

Keywords

  • FAILURE

Cite this

KHAN, I. H., CATTO, G. R. D., EDWARD, N., FLEMING, L. W., HENDERSON, I. S., & MACLEOD, A. M. (1993). INFLUENCE OF COEXISTING DISEASE ON SURVIVAL ON RENAL-REPLACEMENT THERAPY. The Lancet, 341(8842), 415-418. https://doi.org/10.1016/0140-6736(93)93003-J