CKD in elderly patients managed without dialysis: Survival, symptoms, and quality of life

Clinical Journal of the American Society of Nephrology

Volumn 10, Issue 2, 2015, Pages 260-268

  Brown, Mark A ^a,b   Collett, Gemma K ^a   Josland, Elizabeth A ^a   Foote, Celine ^c   Li, Qiang ^c   Brennan, Frank P ^a  

^a ST GEORGE HOSPITAL   (Australia)

^b UNIVERSITY OF NEW SOUTH WALES   (Australia)

^c GEORGE INSTITUTE FOR GLOBAL HEALTH   (Australia)

Author keywords

[No Author keywords available]

Indexed keywords

ADULT; AGED; ALBUMIN BLOOD LEVEL; ARTICLE; CHRONIC KIDNEY DISEASE; CREATININE BLOOD LEVEL; DIABETES MELLITUS; DIALYSIS; FEMALE; GLOMERULUS FILTRATION RATE; HEART FAILURE; HEMODIALYSIS; HUMAN; MAJOR CLINICAL STUDY; MALE; MEMORIAL SYMPTOM ASSESSMENT SCALE; OBSERVATIONAL STUDY; OUTCOME ASSESSMENT; PARATHYROID HORMONE BLOOD LEVEL; PROSPECTIVE STUDY; QUALITY OF LIFE; SHORT FORM 36; SURVIVAL; SYMPTOM; SYMPTOM ASSESSMENT; VASCULAR DISEASE; ADVERSE EFFECTS; AGE; AGING; ATTITUDE TO HEALTH; COMPLICATION; COST OF ILLNESS; DECISION MAKING; EPIDEMIOLOGY; MIDDLE AGED; MORTALITY; NEW SOUTH WALES; PALLIATIVE THERAPY; PATIENT; PATIENT PARTICIPATION; PROGNOSIS; PROPORTIONAL HAZARDS MODEL; PSYCHOLOGY; QUESTIONNAIRE; RENAL INSUFFICIENCY, CHRONIC; RISK FACTOR; TIME FACTOR; TREATMENT REFUSAL; VERY ELDERLY;

AGE FACTORS; AGED; AGED, 80 AND OVER; AGING; CHOICE BEHAVIOR; COST OF ILLNESS; FEMALE; HEALTH KNOWLEDGE, ATTITUDES, PRACTICE; HUMANS; MALE; MIDDLE AGED; NEW SOUTH WALES; PALLIATIVE CARE; PATIENT PARTICIPATION; PATIENTS; PROGNOSIS; PROPORTIONAL HAZARDS MODELS; PROSPECTIVE STUDIES; QUALITY OF LIFE; RENAL DIALYSIS; RENAL INSUFFICIENCY, CHRONIC; RISK FACTORS; SURVEYS AND QUESTIONNAIRES; TIME FACTORS; TREATMENT REFUSAL;

EID: 84923833607     PISSN: 15559041     EISSN: 1555905X     Source Type: Journal    
DOI: 10.2215/CJN.03330414     Document Type: Article

References (40)

1. Swidler MA: Geriatric renal palliative care. J Gerontol A Biol Sci Med Sci 67: 1400–1409, 2012.
2. Australian and New Zealand Dialysis and Transplant Registry: ANZDATA 35th Annual Report, Adelaide, South Australia, ANZDATA, 2012.
3. US Renal Data System: Incidence, prevelance, patient characteristics, and treatment modalities, 2013. Available at: http://www.usrds.org/2013/pdf/v2_ch1_13.pdf. Accessed October 22, 2014.
4. UK Renal Registry: UK RRT Incidence in 2011: National and centre-specific analyses, 2011. Available at: http://www.renalreg.org/wp-content/uploads/2014/09/Chapter_1.pdf. Accessed October 22, 2014.
5. Brown MA, Crail SM, Masterson R, Foote C, Robins J, Katz I, Josland E, Brennan F, Stallworthy EJ, Brennan F, Siva B, Crail S, Brennan F, Siva B, Brennan F, Brown M, Miller C, Urban AK, Sajiv C, Stallworthy EJ, Glavish RN, May S, Langham R, Walker R, Fassett RG, Morton RL, Crail SM, Stewart C, Brennan F, Phipps L, Walker R, Healy H, Berquier I, Crail SM; Australian and New Zealand Society of Nephrology: ANZSN renal supportive care 2013: Opinion pieces [corrected]. Nephrology (Carlton) 18: 401–454, 2013.
6. Hutchison AJ, Smith CP, Brenchley PEC: Pharmacology, efficacy and safety of oral phosphate binders. Nat Rev Nephrol 7: 578–589, 2011.
7. Foote C, Ninomiya T, Gallagher M, Perkovic V, Cass A, McDonald SP, Jardine M: Survival of elderly dialysis patients is predicted by both patient and practice characteristics. Nephrol Dial Transplant 27: 3581–3587, 2012.
8. Murtagh FEM, Addington-Hall JM, Edmonds PM, Donohoe P, Carey I, Jenkins K, Higginson IJ: Symptoms in advanced renal disease: A cross-sectional survey of symptom prevalence in stage 5 chronic kidney disease managedwithout dialysis. J Palliat Med 10: 1266–1276, 2007.
9. Kurella Tamura M, Covinsky KE, Chertow GM, Yaffe K, Landefeld CS, McCulloch CE: Functional status of elderly adults before and after initiation of dialysis. N Engl J Med 361: 1539–1547, 2009.
10. Rosansky SJ: The sad truth about early initiation of dialysis in elderly patients. JAMA 307: 1919–1920, 2012.
11. Schell JO, Patel UD, Steinhauser KE, Ammarell N, Tulsky JA: Discussions of the kidney disease trajectory by elderly patients and nephrologists: A qualitative study. Am J Kidney Dis 59: 495–503, 2012.
12. von Elm E, Altman DG, Egger M, Pocock SJ, Gøtzsche PC, Vandenbroucke JP; STROBE Initiative: Strengthening the Reporting of Observational Studies in Epidemiology (STROBE) statement: Guidelines for reporting observational studies. BMJ 335: 806–808, 2007.
13. Renal Physicians Association: Shared Decision Making in the Appropriate Initiation of and Withdrawal from Dialysis, 2nd Ed., Rockville, MD, Renal Physicians Association, 2010.
14. Moss AH: Revised dialysis clinical practice guideline promotes more informed decision-making. Clin J AmSoc Nephrol 5: 2380–2383, 2010.
15. Moss AH, Ganjoo J, Sharma S, Gansor J, Senft S, Weaner B, Dalton C, MacKay K, Pellegrino B, Anantharaman P, Schmidt R: Utility of the “surprise” question to identify dialysis patients with high mortality. Clin J Am Soc Nephrol 3: 1379–1384, 2008.
16. Visser R, Dekker FW, Boeschoten EW, Stevens P, Krediet RT: Reliability of the 7-point subjective global assessment scale in assessing nutritional status of dialysis patients. Adv Perit Dial 15: 222–225, 1999.
17. Chang VT, Hwang SS, Feuerman M, Kasimis BS, Thaler HT: The memorial symptom assessment scale short form (MSAS-SF). Cancer 89: 1162–1171, 2000.
18. McHorney CA, Ware JE Jr, Raczek AE; Psychometric and Clinical Tests of Validity in Measuring Physical and Mental Health Constructs: The MOS 36-Item Short-Form Health Survey (SF-36): II. Psychometric and clinical tests of validity in measuring physical and mental health constructs. Med Care 31: 247–263, 1993.
19. Hosmer DW, Lemeshow S: Applied Logistic Regression, 2nd Ed., Hoboken, NJ, John Wiley & Sons Inc, 2000.
20. Murtagh FEM, Marsh JE, Donohoe P, Ekbal NJ, Sheerin NS, Harris FE: Dialysis or not? A comparative survival study of patients over 75 years with chronic kidney disease stage 5. Nephrol Dial Transplant 22: 1955–1962, 2007.
21. Dasgupta I, Rayner HC: In good conscience—Safelywithholding dialysis in the elderly. Semin Dial 22: 476–479, 2009.
22. Swidler M: Considerations in starting a patient with advanced frailty on dialysis: Complex biology meets challenging ethics. Clin J Am Soc Nephrol 8: 1421–1428, 2013.
23. Crail S, Walker R, Brown M; Renal Supportive Care Working Group: Renal supportive and palliative care: Position statement. Nephrology (Carlton) 18: 393–400, 2013.
24. Brennan F, Brown M: An ethical approach to dialysis—An alliance of nephrology, palliative medicine and ethics. QJM 106: 397–400, 2013.
25. Williams ME: Tough choices: Dialysis, palliative care, or a third option for elderly ESRD. Semin Dial 25: 633–639, 2012.
26. Brown EA: Non-dialysis therapy: A better policy than dialysis followed by withdrawal? Semin Dial 25: 26–27, 2012.
27. O’Connor NR, Kumar P: Conservative management of end-stage renal disease without dialysis: A systematic review. J Palliat Med 15: 228–235, 2012.
28. Carson RC, Juszczak M, Davenport A, Burns A: Is maximum conservative management an equivalent treatment option to dialysis for elderly patients with significant comorbid disease? Clin J Am Soc Nephrol 4: 1611–1619, 2009.
29. Chandna SM, Da Silva-Gane M, Marshall C, Warwicker P, Greenwood RN, Farrington K: Survival of elderly patientswith stage 5 CKD: comparison of conservative management and renal replacement therapy. Nephrol Dial Transplant 26: 1608–1614, 2011.
30. Ellam T, El-Kossi M, Prasanth KC, El-Nahas M, Khwaja A: Conservatively managed patients with stage 5 chronic kidney disease—Outcomes from a single center experience. QJM 102: 547–554, 2009.
31. Joly D, Anglicheau D, Alberti C, Nguyen AT, Touam M, Gru¨nfeld JP, Jungers P: Octogenarians reaching end-stage renal disease: Cohort study of decision-making and clinical outcomes. J AmSoc Nephrol 14: 1012–1021, 2003.
32. Smith C, Da Silva-Gane M, Chandna S, Warwicker P, Greenwood R, Farrington K: Choosing not to dialyse: Evaluation of planned non-dialytic management in a cohort of patients with end-stage renal failure. Nephron Clin Pract 95: c40–c46, 2003.
33. Wong CF, McCarthy M, Howse MLP, Williams PS: Factors affecting survival in advanced chronic kidney disease patients who choose not to receive dialysis. Ren Fail 29: 653–659, 2007.
34. Hussain JA, Mooney A, Russon L:Comparison of survival analysis and palliative care involvement in patients aged over 70 years choosing conservative management or renal replacement therapy in advanced chronic kidney disease. Palliat Med 27: 829–839, 2013.
35. Kidney Disease Improving Global Outcomes: 2012 Clinical Practice Guideline for the Evaluation and Management of Chronic Kidney Disease. Chapter 5: Referral to specialists and models of care. Kidney Int Suppl 3: 112–119, 2013.
36. Kane PM, Vinen K, Murtagh FE: Palliative care for advanced renal disease: A summary of the evidence and future direction. Palliat Med 27: 817–821, 2013.
37. Da Silva-Gane M, Wellsted D, Greenshields H, Norton S, Chandna SM, Farrington K: Quality of life and survival in patients with advanced kidney failure managed conservatively or by dialysis. Clin J Am Soc Nephrol 7: 2002–2009, 2012.
38. Klemenc-Ketis Z, Smogavec M, Softic N, Kersnik J: Healthrelated quality of life: A population based study from Slovenia. Cent Eur J Public Health 19: 7–12, 2011.
39. Challah S, Wing AJ, Bauer R, Morris RW, Schroeder SA: Negative selection of patients for dialysis and transplantation in the United Kingdom. Br Med J (Clin Res Ed) 288: 1119–1122, 1984.
40. Visser A, Dijkstra GJ, Kuiper D, de Jong PE, Franssen CF, Gansevoort RT, Izaks GJ, Jager KJ, Reijneveld SA: Accepting or declining dialysis: considerations taken into account by elderly patients with end-stage renal disease. J Nephrol 22: 794–799, 2009.