Comorbidities and current smoking status amongst patients starting renal replacement therapy in England, Wales and Northern Ireland from 2003 to 2008: national and centre-specific analyses

F. Caskey, L. Webb, J. Gilg, Damian Fogarty

Research output: Chapter in Book/Report/Conference proceedingChapter (peer-reviewed)

3 Citations (Scopus)
104 Downloads (Pure)

Abstract

Introduction: The prevalence of comorbidities in incident renal replacement therapy (RRT) patients changes with age and varies between ethnic groups. This study describes these associations and the independent effect of comorbidities on outcomes. Methods: Adult patients starting RRT between 2003 and 2008 in centres reporting to the UK Renal Registry (UKRR) with data on comorbidity (n ¼ 14,909) were included. The UKRR studied the association of comorbidity with patient demographics, treatment modality, haemoglobin, renal function at start of RRT and subsequent listing for kidney transplantation. The relationship between comorbidities and mortality at 90 days and one year after 90 days from start of RRT was explored using Cox regression. Results: Completeness of comorbidity data was 40.0% compared with 54.3% in 2003. Of patients with data, 53.8% had one or more comorbidities. Diabetes mellitus and ischaemic heart disease were the most common conditions seen in 30.1% and 22.7% of patients respectively. Current smoking was recorded for 14.5% of incident RRT patients in the 6-year period. Comorbidities became more common with increasing age in all ethnic groups although the difference between the 65–74 and 75+ age groups was not significant. Within each age group, South Asians and Blacks had lower rates of comorbidity, despite higher rates of diabetes mellitus. In multivariate survival analysis, malignancy and ischaemic/neuropathic ulcers were the strongest independent predictors of poor survival at 1 year after 90 days from the start of RRT. Conclusion: Differences in prevalence of comorbid illnesses in incident RRT patients may reflect variation in access to health care or competing risk prior to commencing treatment. At the same time, smoking rates remained high in this ‘at risk’ population. Further work on this and ways to improve comorbidity reporting should be priorities for 2010–11.
Original languageEnglish
Title of host publicationUK Renal Registry 12th Annual Report (December 2009)
PublisherKarger
Pagesc103-c116
Number of pages14
Volume115 Suppl 1
DOIs
Publication statusPublished - 2010

Publication series

NameNephron Clinical Practice
PublisherKarger
Volume115 (suppl. 1)

Fingerprint

Northern Ireland
Renal Replacement Therapy
Wales
England
Comorbidity
Smoking
Kidney
Ethnic Groups
Registries
Diabetes Mellitus
Age Groups
Health Services Accessibility
Survival Analysis
Kidney Transplantation
Ulcer
Myocardial Ischemia
Hemoglobins
Multivariate Analysis
Demography

Cite this

Caskey, F., Webb, L., Gilg, J., & Fogarty, D. (2010). Comorbidities and current smoking status amongst patients starting renal replacement therapy in England, Wales and Northern Ireland from 2003 to 2008: national and centre-specific analyses. In UK Renal Registry 12th Annual Report (December 2009) (Vol. 115 Suppl 1, pp. c103-c116). (Nephron Clinical Practice; Vol. 115 (suppl. 1)). Karger. https://doi.org/10.1159/000301161
Caskey, F. ; Webb, L. ; Gilg, J. ; Fogarty, Damian. / Comorbidities and current smoking status amongst patients starting renal replacement therapy in England, Wales and Northern Ireland from 2003 to 2008: national and centre-specific analyses. UK Renal Registry 12th Annual Report (December 2009). Vol. 115 Suppl 1 Karger, 2010. pp. c103-c116 (Nephron Clinical Practice).
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Caskey, F, Webb, L, Gilg, J & Fogarty, D 2010, Comorbidities and current smoking status amongst patients starting renal replacement therapy in England, Wales and Northern Ireland from 2003 to 2008: national and centre-specific analyses. in UK Renal Registry 12th Annual Report (December 2009). vol. 115 Suppl 1, Nephron Clinical Practice, vol. 115 (suppl. 1), Karger, pp. c103-c116. https://doi.org/10.1159/000301161

Comorbidities and current smoking status amongst patients starting renal replacement therapy in England, Wales and Northern Ireland from 2003 to 2008: national and centre-specific analyses. / Caskey, F.; Webb, L.; Gilg, J.; Fogarty, Damian.

UK Renal Registry 12th Annual Report (December 2009). Vol. 115 Suppl 1 Karger, 2010. p. c103-c116 (Nephron Clinical Practice; Vol. 115 (suppl. 1)).

Research output: Chapter in Book/Report/Conference proceedingChapter (peer-reviewed)

TY - CHAP

T1 - Comorbidities and current smoking status amongst patients starting renal replacement therapy in England, Wales and Northern Ireland from 2003 to 2008: national and centre-specific analyses

AU - Caskey, F.

AU - Webb, L.

AU - Gilg, J.

AU - Fogarty, Damian

PY - 2010

Y1 - 2010

N2 - Introduction: The prevalence of comorbidities in incident renal replacement therapy (RRT) patients changes with age and varies between ethnic groups. This study describes these associations and the independent effect of comorbidities on outcomes. Methods: Adult patients starting RRT between 2003 and 2008 in centres reporting to the UK Renal Registry (UKRR) with data on comorbidity (n ¼ 14,909) were included. The UKRR studied the association of comorbidity with patient demographics, treatment modality, haemoglobin, renal function at start of RRT and subsequent listing for kidney transplantation. The relationship between comorbidities and mortality at 90 days and one year after 90 days from start of RRT was explored using Cox regression. Results: Completeness of comorbidity data was 40.0% compared with 54.3% in 2003. Of patients with data, 53.8% had one or more comorbidities. Diabetes mellitus and ischaemic heart disease were the most common conditions seen in 30.1% and 22.7% of patients respectively. Current smoking was recorded for 14.5% of incident RRT patients in the 6-year period. Comorbidities became more common with increasing age in all ethnic groups although the difference between the 65–74 and 75+ age groups was not significant. Within each age group, South Asians and Blacks had lower rates of comorbidity, despite higher rates of diabetes mellitus. In multivariate survival analysis, malignancy and ischaemic/neuropathic ulcers were the strongest independent predictors of poor survival at 1 year after 90 days from the start of RRT. Conclusion: Differences in prevalence of comorbid illnesses in incident RRT patients may reflect variation in access to health care or competing risk prior to commencing treatment. At the same time, smoking rates remained high in this ‘at risk’ population. Further work on this and ways to improve comorbidity reporting should be priorities for 2010–11.

AB - Introduction: The prevalence of comorbidities in incident renal replacement therapy (RRT) patients changes with age and varies between ethnic groups. This study describes these associations and the independent effect of comorbidities on outcomes. Methods: Adult patients starting RRT between 2003 and 2008 in centres reporting to the UK Renal Registry (UKRR) with data on comorbidity (n ¼ 14,909) were included. The UKRR studied the association of comorbidity with patient demographics, treatment modality, haemoglobin, renal function at start of RRT and subsequent listing for kidney transplantation. The relationship between comorbidities and mortality at 90 days and one year after 90 days from start of RRT was explored using Cox regression. Results: Completeness of comorbidity data was 40.0% compared with 54.3% in 2003. Of patients with data, 53.8% had one or more comorbidities. Diabetes mellitus and ischaemic heart disease were the most common conditions seen in 30.1% and 22.7% of patients respectively. Current smoking was recorded for 14.5% of incident RRT patients in the 6-year period. Comorbidities became more common with increasing age in all ethnic groups although the difference between the 65–74 and 75+ age groups was not significant. Within each age group, South Asians and Blacks had lower rates of comorbidity, despite higher rates of diabetes mellitus. In multivariate survival analysis, malignancy and ischaemic/neuropathic ulcers were the strongest independent predictors of poor survival at 1 year after 90 days from the start of RRT. Conclusion: Differences in prevalence of comorbid illnesses in incident RRT patients may reflect variation in access to health care or competing risk prior to commencing treatment. At the same time, smoking rates remained high in this ‘at risk’ population. Further work on this and ways to improve comorbidity reporting should be priorities for 2010–11.

U2 - 10.1159/000301161

DO - 10.1159/000301161

M3 - Chapter (peer-reviewed)

VL - 115 Suppl 1

T3 - Nephron Clinical Practice

SP - c103-c116

BT - UK Renal Registry 12th Annual Report (December 2009)

PB - Karger

ER -

Caskey F, Webb L, Gilg J, Fogarty D. Comorbidities and current smoking status amongst patients starting renal replacement therapy in England, Wales and Northern Ireland from 2003 to 2008: national and centre-specific analyses. In UK Renal Registry 12th Annual Report (December 2009). Vol. 115 Suppl 1. Karger. 2010. p. c103-c116. (Nephron Clinical Practice). https://doi.org/10.1159/000301161