Prognosis of CKD Patients Receiving Outpatient Nephrology Care in Italy
| Autor: | DE NICOLA, Luca, CHIODINI, Paolo, ZOCCALI C, BORRELLI S, CIANCIARUSO B, DI IORIO B, SANTORO D, GIANCASPRO V, ABATERUSSO C, GALLO, Ciro, CONTE, Giuseppe, MINUTOLO, Roberto, FOR THE SIN TABLE CKD STUDY GROUP, ZAMBOLI, Pasquale |
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| Přispěvatelé: | DE NICOLA, Luca, Chiodini, Paolo, Zoccali, C, Borrelli, S, Cianciaruso, B, DI IORIO, B, Santoro, D, Giancaspro, V, Abaterusso, C, Gallo, Ciro, Conte, Giuseppe, Minutolo, Roberto, FOR THE SIN TABLE CKD STUDY, Group, Zamboli, Pasquale, De Nicola, L, Chiodini, P, Cianciaruso, Bruno, Di Iorio, B, Gallo, C, Conte, G, Minutolo, R, SIN TABLE CKD Study, Group |
| Jazyk: | angličtina |
| Rok vydání: | 2011 |
| Předmět: |
Nephrology
Male Time Factors Epidemiology Kaplan-Meier Estimate urologic and male genital diseases Critical Care and Intensive Care Medicine Severity of Illness Index Risk Factors Ambulatory Care Cumulative incidence Prospective Studies Prospective cohort study Aged 80 and over education.field_of_study Incidence Continuity of Patient Care Middle Aged female genital diseases and pregnancy complications Proteinuria Treatment Outcome Italy Cohort Disease Progression Female Kidney Diseases Glomerular Filtration Rate medicine.medical_specialty Population CKD conservative treatment Risk Assessment Ambulatory care Internal medicine Severity of illness medicine Humans Intensive care medicine education Aged Proportional Hazards Models Transplantation Analysis of Variance Chi-Square Distribution business.industry Original Articles medicine.disease nephrology care Nonlinear Dynamics Kidney Failure Chronic business Kidney disease |
| Popis: | Prognosis in nondialysis chronic kidney disease (CKD) patients under regular nephrology care is rarely investigated. Design, setting, participants,measurements We prospectively followed from 2003 to death or June 2010 a cohort of 1248 patients with CKD stages 3 to 5 and previous nephrology care ≥1 year in 25 Italian outpatient nephrology clinics. Cumulative incidence of ESRD or death before ESRD were estimated using the competing-risk approach.Estimated rates (per 100 patient-years) of ESRD and death 8.3 (95% confidence interval [CI], 7.4 to 9.2) and 5.9 (95% CI 5.2 to 6.6), respectively. Risk of ESRD and death increased progressively from stages 3 to 5. ESRD was more frequent than death in stage 4 and 5 CKD, whereas the opposite was true in stage 3 CKD. Younger age, lower body mass index, proteinuria, and high phosphate predicted ESRD, whereas older age, diabetes, previous cardiovascular disease, ESRD, proteinuria, high uric acid, and anemia predicted death (P0.05 for all). Among modifiable risk factors, proteinuria accounted for the greatest contribution to the model fit for either outcome.In patients receiving continuity of care in Italian nephrology clinics, ESRD was a more frequent outcome than death in stage 4 and 5 CKD, but the opposite was true in stage 3. Outcomes were predicted by modifiable risk factors specific to CKD. Proteinuria used in conjunction with estimated GFR refined risk stratification. These findings provide information, specific to CKD patients under regular outpatient nephrology care, for risk stratification that complement recent observations in the general population. |
| Databáze: | OpenAIRE |
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