Functional Status and Mortality in Chronic Kidney Disease: Results from a Prospective Observational Study

被引:14
作者
Ritchie, James P. [1 ]
Alderson, Helen [1 ]
Green, Darren [1 ]
Chiu, Diana [1 ]
Sinha, Smeeta [1 ]
Middleton, Rachel [1 ]
O'Donoghue, Donal [1 ]
Kalra, Philip A. [1 ]
机构
[1] Salford Royal Hosp, Manchester Acad Hlth Sci Ctr, Vasc Res Grp, Salford M6 8HD, Lancs, England
来源
NEPHRON CLINICAL PRACTICE | 2014年 / 128卷 / 1-2期
关键词
Functional status; Mortality; Chronic kidney disease; Progression; QUALITY-OF-LIFE; STAGE RENAL-DISEASE; RISK; PROGRESSION; DECLINE; GFR; ASSOCIATION; MARKER;
D O I
10.1159/000362453
中图分类号
R5 [内科学]; R69 [泌尿科学(泌尿生殖系疾病)];
学科分类号
1002 ; 100201 ;
摘要
Background/Aims: Measures of functional status are used in the general population to aid prognostication but their use has not been explored in pre-dialysis chronic kidney disease (CKD). This analysis considers the association between the Karnofsky performance score (KPS) and all-cause mortality in a CKD stage 3-5 cohort. Methods: Patients were selected from the Chronic Renal Insufficiency Standards Implementation Study (CRISIS), a prospective observational study of outcome in CKD. Risk for death was assessed using multivariate Cox regression, and differences in progression of biochemical parameters were considered in a mixed-effects model. Results: A total of 1,515 patients with a median follow-up time of 2.9 (1.5-4.8) years were considered. Baseline age was 60 +/- 11 years and eGFR was 30 +/- 12 ml/min/1.73 m(2). Patients with a reduced KPS had an increased risk for death. The hazard ratio (HR) for death was: KPS 90 group, HR 1.2 (95% CI 0.9-1.5), p = 0.1; KPS <= 80 group, HR 1.8 (95% CI 1.4-2.4), p < 0.001. In the mixed-effects model, the average annual loss of eGFR was greater in patients with a KPS <= 80 versus patients with a KPS >80 (5 vs. 3%, p = 0.008). Conclusion: A reduced KPS is independently associated with risk for mortality in patients with CKD stages 3-5. This may relate to a more rapid loss of eGFR. (C) 2014 S. Karger AG, Basel
引用
收藏
页码:22 / 28
页数:7
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