TY - CHAP
T1 - Comorbidities and current smoking status amongst patients starting renal replacement therapy in England, Wales and Northern Ireland: national and centre-specific analyses
AU - Udayaraj, U.
AU - Tomson, C.R.V.
AU - Gilg, J.
AU - Ansell, D.
AU - Fogarty, Damian
PY - 2009
Y1 - 2009
N2 - Introduction: The prevalence of 13 comorbid conditions
and smoking status at the time of starting renal replacement
therapy (RRT) in England, Wales and Northern Ireland
are described. Methods: Adult patients starting RRT
between 2002 and 2007 in centres reporting to the UK
Renal Registry (UKRR) and with data on comorbidity
(n¼13,293) were included. The association of comorbidity
with patient demographics, treatment modality, haemoglobin,
renal function at start of RRT and subsequent listing
for kidney transplantation were studied. Association
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 data on comorbidity
returned to the UKRR remained poor. Of patients
with data, 52% had one or more comorbidities. Diabetes
mellitus and ischaemic heart disease were the most
common conditions seen in 28.9% and 22.5% of patients
respectively. Comorbidities became more common with
increasing age (up to the 65–74 age group), were more
common amongst Whites and were associated with a
lower likelihood of pre-emptive transplantation, a greater
likelihood of starting on haemodialysis (rather than peritoneal
dialysis) and a lower likelihood of being listed for
kidney transplantation. In multivariable survival analysis,
malignancy and ischaemic/neuropathic ulcers were the
strongest predictors of poor survival at 1 year after 90
days from start of RRT. Conclusions: The majority of patients
had at least one comorbid condition and comorbidity is an
important predictor of early mortality on RRT.
AB - Introduction: The prevalence of 13 comorbid conditions
and smoking status at the time of starting renal replacement
therapy (RRT) in England, Wales and Northern Ireland
are described. Methods: Adult patients starting RRT
between 2002 and 2007 in centres reporting to the UK
Renal Registry (UKRR) and with data on comorbidity
(n¼13,293) were included. The association of comorbidity
with patient demographics, treatment modality, haemoglobin,
renal function at start of RRT and subsequent listing
for kidney transplantation were studied. Association
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 data on comorbidity
returned to the UKRR remained poor. Of patients
with data, 52% had one or more comorbidities. Diabetes
mellitus and ischaemic heart disease were the most
common conditions seen in 28.9% and 22.5% of patients
respectively. Comorbidities became more common with
increasing age (up to the 65–74 age group), were more
common amongst Whites and were associated with a
lower likelihood of pre-emptive transplantation, a greater
likelihood of starting on haemodialysis (rather than peritoneal
dialysis) and a lower likelihood of being listed for
kidney transplantation. In multivariable survival analysis,
malignancy and ischaemic/neuropathic ulcers were the
strongest predictors of poor survival at 1 year after 90
days from start of RRT. Conclusions: The majority of patients
had at least one comorbid condition and comorbidity is an
important predictor of early mortality on RRT.
U2 - 10.1159/000209995
DO - 10.1159/000209995
M3 - Chapter (peer-reviewed)
VL - 111
T3 - Nephron Clinical Practice
SP - c97-c111
BT - UK Renal Registry 11th Annual Report (December 2008)
PB - Karger
ER -