Original investigation: dialysis therapyAdapting the charlson comorbidity index for use in patients with ESRD
Section snippets
Data source and patient selection
The Southern Alberta Renal Program (SARP) provides care to all patients with ESRD in the southern portion of Alberta, Canada. A computerized database of all predialysis, dialysis, and kidney transplantation patients in this catchment area of 1.3 million people is maintained by SARP20 and was used to identify study subjects. The province of Alberta overall has a population of approximately 2.8 million persons, of whom 10% identify themselves as ethnic minorities (3.5%, Chinese ethnicity; 2%,
Results
Table 1 lists characteristics of the 237 incident patients with ESRD. The majority of subjects were men, with a mean age of 62.5 years. The mortality rate for the study period was 23.6%. In terms of modality, 77.6% of subjects were on hemodialysis therapy, with the remaining 22.4% on peritoneal dialysis therapy. Primary causes of ESRD in this population were diabetes, glomerulonephritis, and hypertension/ischemic nephropathy.
The original Charlson comorbidity score and new ESRD comorbidity
Discussion
In this study, we evaluated the ability of the Charlson Comorbidity Index to predict survival in a population of incident patients with ESRD, and developed a new ESRD comorbidity index specific for dialysis patients based on original Charlson Comorbidity Index variables. Results suggest that the original Charlson index is a valid tool to assess comorbidity and predict survival in this dialysis population. Further validation in a separate data set is needed to acquire more information on the
References (27)
- et al.
Canadian hemodialysis morbidity study
Am J Kidney Dis
(1992) - et al.
Advance prediction of early death in patients starting maintenance dialysis
Am J Kidney Dis
(1994) - et al.
Influence of coexisting disease on survival on renal-replacement therapy
Lancet
(1993) - et al.
Influence of co-morbidity on mortality and morbidity in patients treated with hemodialysis
Am J Kidney Dis
(1994) - et al.
Urea index and other predictors of hemodialysis patient survival
Am J Kidney Dis
(1994) - et al.
Comorbidity, urea kinetics, and appetite in continuous ambulatory peritoneal dialysis patientsTheir interrelationship and prediction of survival
Am J Kidney Dis
(1995) - et al.
Comorbidity assessment using the Index of Coexistent Diseases in a multicenter clinical trial
Kidney Int
(2001) - et al.
A new method of classifying prognostic comorbidity in longitudinal studiesDevelopment and validation
J Chronic Dis
(1987) Measuring comorbidity in older cancer patients
Eur J Cancer
(2000)- et al.
Correlates of early hospital readmission or death in patients with congestive heart failure
Am J Cardiol
(1997)
A simple comorbidity scale predicts clinical outcomes and costs in dialysis patients
Am J Med
Charlson Comorbidity Index as a predictor of outcomes in incident peritoneal dialysis patients
Am J Kidney Dis
How to adjust for comorbidity in survival studies in ESRD patientsA comparison of different indices
Am J Kidney Dis
Cited by (0)
Supported in part by the Alberta Heritage Foundation for Medical Research; Health Research Fund Center for Advancement of Health, Calgary Health Region; a Government of Canada Research Chair (W.A.G.); and a Health Scholar Award from the Alberta Heritage Foundation for Medical Research (W.A.G.).