Specialist follow up of patients before end stage renal failure and its relationship to survival on dialysis
| Autor: | C G Newstead, J Stoves, C N Bartlett |
|---|---|
| Rok vydání: | 2001 |
| Předmět: |
Adult
Male medicine.medical_specialty Time Factors medicine.medical_treatment Peritoneal dialysis Renal Dialysis Risk Factors Internal medicine medicine Humans Survival rate Referral and Consultation Survival analysis Dialysis Serum Albumin Aged Retrospective Studies business.industry Proportional hazards model Mortality rate Age Factors General Medicine Original Articles Middle Aged medicine.disease Prognosis Surgery Survival Rate England Kidney Failure Chronic Female Hemodialysis business Kidney disease Follow-Up Studies |
| Zdroj: | Postgraduate medical journal. 77(911) |
| ISSN: | 0032-5473 |
| Popis: | The high mortality rate of patients with end stage renal failure (ESRF) treated by dialysis is determined principally by irreversible factors such as age and comorbidity. In this single centre retrospective study of all 1260 ESRF patients who started dialysis between 1980 and 1999 it has been demonstrated that a short duration of specialist predialysis follow up is associated with a worse long term outcome on dialysis. Kaplan-Meier survival curves were plotted according to duration of predialysis follow up (group A, ⩽ 90 days; group B >90 days), censoring for first transplant, and compared using a log rank test. Differences between groups were examined using an unpaired t test. Cox regression analysis was performed to examine the influence of selected variables on survival. Group A had the worst mortality (survival proportions of 87%, 74%, and 31% in A and 94%, 87%, and 55% in B at four months, one year, and five years respectively, p In summary, this study strengthens the previously reported association between late referral of ESRF patients and subsequent poor survival on dialysis. This important message is relevant to all potential referring physicians. Key pointsThe high mortality rate of patients with ESRF treated by dialysis is determined principally by irreversible factors such as age and comorbidity.We have demonstrated in a single centre retrospective study of more than 1200 patients with ESRF that a short duration of specialist predialysis follow up is associated with an increased risk of death on dialysis, principally during the first few months of treatment.Delays in the referral to renal specialist services of patients with advanced chronic renal failure should be minimised. |
| Databáze: | OpenAIRE |
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