UK Renal Registry 11th Annual Report (December 2008): Chapter 6 Comorbidities and current smoking status amongst patients starting renal replacement therapy in England, Wales and Northern Ireland: national and centre-specific analyses.
BACKGROUND
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 (n = 13,293) 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.
Udayaraj
Udaya
U
UK Renal Registry, Southmead Hospital, Bristol, UK. renalreg@renalreg.com
Tomson
Charles R V
CR
Gilg
Julie
J
Ansell
David
D
Fogarty
Damian
D
D000328:Adult; D015897:Comorbidity; D005260:Female; D006801:Humans; D007676:Kidney Failure, Chronic / Q000401:mortality* / Q000628:therapy*; D008297:Male; D008875:Middle Aged; D015995:Prevalence; D012042:Registries; D017582:Renal Replacement Therapy / Q000401:mortality*; D012907:Smoking / Q000453:epidemiology*; D016019:Survival Analysis; D015996:Survival Rate; D016896:Treatment Outcome; D006113:United Kingdom / Q000453:epidemiology