Competing risks of death and kidney failure in a cohort of Australian adults with severe chronic kidney disease.
Age Factors
Aged
Aged, 80 and over
Datasets as Topic
Disease Progression
Female
Glomerular Filtration Rate
Humans
Incidence
Kidney Transplantation
Male
Middle Aged
Renal Dialysis
Renal Insufficiency
/ mortality
Renal Insufficiency, Chronic
/ mortality
Retrospective Studies
Risk Factors
Tasmania
/ epidemiology
Kidney diseases
Kidney transplantation
Renal dialysis
Journal
The Medical journal of Australia
ISSN: 1326-5377
Titre abrégé: Med J Aust
Pays: Australia
ID NLM: 0400714
Informations de publication
Date de publication:
21 Feb 2022
21 Feb 2022
Historique:
revised:
09
07
2021
received:
08
01
2021
accepted:
21
07
2021
pubmed:
7
12
2021
medline:
5
3
2022
entrez:
6
12
2021
Statut:
ppublish
Résumé
To examine the competing risks of death (any cause) and of kidney failure in a cohort of Australian adults with severe chronic kidney disease. Population-based cohort study; analysis of linked data from the Tasmanian Chronic Kidney Disease study (CKD.TASlink), 1 January 2004 - 31 December 2017. All adults in Tasmania with incident stage 4 chronic kidney disease (estimated glomerular filtration rate [eGFR], 15-29 mL/min/1.73 m Death or kidney failure (defined as eGFR below 10 mL/min/1.73 m We included data for 6825 adults with incident stage 4 chronic kidney disease (mean age, 79.3 years; SD, 11.1 years), including 3816 women (55.9%). The risk of death increased with age - under 65 years: 0.18 (95% CI, 0.15-0.22); 65-74 years: 0.39 (95% CI, 0.36-0.42); 75-84 years, 0.56 (95% CI, 0.54-0.58); 85 years or older: 0.78 (95% CI, 0.77-0.80) - while that of kidney failure declined - under 65 years: 0.39 (95% CI, 0.35-0.43); 65-74 years: 0.12 (95% CI, 0.10-0.14); 75-84 years: 0.05 (95% CI, 0.04-0.06); 85 years or older: 0.01 (95% CI, 0.01-0.02). The risk of kidney failure was greater for people with macroalbuminuria and those whose albumin status had not recently been assessed. The risks of kidney failure and death were greater for men than women in all age groups (except similar risks of death for men and women under 65 years of age). For older Australians with incident stage 4 chronic kidney disease, the risk of death is higher than that of kidney failure, and the latter risk declines with age. Clinical guidelines should recognise these competing risks and include recommendations about holistic supportive care, not just on preparation for dialysis or transplantation.
Types de publication
Journal Article
Langues
eng
Sous-ensembles de citation
IM
Pagination
140-146Subventions
Organisme : Tasmanian Community Fund
Organisme : Royal Hobart Hospital Research Foundation
ID : 20-201
Commentaires et corrections
Type : CommentIn
Informations de copyright
© 2021 AMPCo Pty Ltd.
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