Conservatively managed patients with stage 5 chronic kidney disease--outcomes from a single center experience.
BACKGROUND
Limited survival data are available on chronic kidney disease stage 5 (CKD 5) patients who opt for conservative management rather than dialysis.


OBJECTIVE
To measure survival in such patients and investigate potential factors predicting survival.


METHODS
Retrospective survival analysis of a cohort of conservatively managed CKD 5 patients from a single center.


METHODS
Survival was measured in 69 conservatively managed patients from the time they were first known to have CKD 5. Comorbidities, residual renal function and other laboratory parameters (calcium, phosphate, parathyroid hormone, albumin and hemoglobin) and blood pressure were recorded.


RESULTS
Overall median patient survival from the time of first known CKD 5 was 21 months. Patients known to a nephrologist before reaching CKD 5 survived longer (median 32 months) than those presenting with CKD 5 (15 months, P = 0.025). Serum albumin >35 g/l was associated with greater survival, but other biochemical parameters, comorbidity grade and age did not predict survival.


CONCLUSIONS
These survival data provide useful information for nephrologists counseling CKD 5 patients considering whether to pursue dialysis or conservative management. Risk factors that correlate with survival in the dialysis population may not predict survival in conservatively managed CKD 5 patients.
Ellam
T
T
Sheffield Kidney Institute, Northern General Hospital, Herries Road, Sheffield, S5 7AU, UK. timellam@doctors.org.uk
El-Kossi
M
M
Prasanth
K C
KC
El-Nahas
M
M
Khwaja
A
A
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D015415:Biomarkers / Q000097:blood; D004739:England; D005260:Female; D006801:Humans; D053208:Kaplan-Meier Estimate; D007676:Kidney Failure, Chronic / Q000401:mortality* / Q000503:physiopathology / Q000628:therapy; D007677:Kidney Function Tests; D008297:Male; D008875:Middle Aged; D006435:Renal Dialysis; D012189:Retrospective Studies; D012307:Risk Factors; D012709:Serum Albumin / Q000032:analysis; D015996:Survival Rate; D013997:Time Factors; D016896:Treatment Outcome; D016312:Treatment Refusal
D015415:Biomarkers; D012709:Serum Albumin