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Multicenter Study
. 2019 Nov-Dec;39(6):629-637.
doi: 10.1016/j.nefro.2019.02.004. Epub 2019 Apr 23.

Advanced chronic renal failure (ACRF) study. Baseline characteristics, evaluation of the application of the structured information for the election of renal replacement therapy and one-year evolution of the incident patients in the ACRF medical office

[Article in English, Spanish]
María Angeles Guerrero Riscos  1 , Francisco Javier Toro Prieto  2 , Paula Batalha Caetano  2 , Mercedes Salgueira Lazo  3 , Fayna González Cabrera  4 , Silvia Marrero Robayna  4 , Raquel Santana Estupiñán  4 , Carlos Álvarez Martín  5
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Free article
Multicenter Study

Advanced chronic renal failure (ACRF) study. Baseline characteristics, evaluation of the application of the structured information for the election of renal replacement therapy and one-year evolution of the incident patients in the ACRF medical office

[Article in English, Spanish]
María Angeles Guerrero Riscos et al. Nefrologia (Engl Ed). 2019 Nov-Dec.
Free article

Abstract

Background and objectives: Analyze evolution Renal Chronic Failure stage 4-5 (ACRF) patients and influence information they receive (educational process, EP) in modality Renal Replacement Therapy (RRT) or conservative treatment (CT) in multidisciplinar ACRF Office.

Material and methods: Prospective, multicenter study (3 centers). Inclusion: from June-01-2014 to October-01-2015; observation: 12 months or until start RRT or death if they occur before 12 months; ends October-01-2016.

Results: 336 patients were included (60% males), median and intercuartile rank 71.5 (17), 55% ≥ 70 years; Follow up initiation eGFR CKD-EPI: 21 (9) ml / min / 1.73m2; Charlson Index (ChI) with / without age 8 (3) / 4 (2); Diabetic patients: 52,4%. The EP was carried out in 168, eGFR 15 (10) ml / min / 1.73m2. The initial treatment election: 26% peritoneal dialysis (PD), 45% hemodyalisis (HD), 26% CT, kidney trasplant 3%; 60 patients started RRT: 3.3% kidney traspant; 30% PD, 66% HD; 104 admissions in 73 patients, the most frequent cause: cardiovascular disease (42%). Fallecimiento: 23 patients (6.8%). Age was higher (78.4 (6) vs. 67.8 (13.4), P<.001), higher ChI 9.8 (2.1) vs. 7.4 (2.5), P<.001). All deceased who received EP had chosen CT; 61% of deceased had at least one hospital admission vs. 39% alive (P<0.001). Cox regression: age and Charlson index were the predictive mortality variables.

Conclusions: The population of ACRF patients is elder, comorbid, with high rate hospitalizations rate. The PD election is higher than usual. The EP has been very useful tool and has favored the PD choice.

Keywords: Advanced renal chronic failure; Conservative treatment; Diálisis domiciliaria; Educational process; Elección de tratamiento renal sustitutivo; Enfermedad renal crónica avanzada; Home dialysis; Proceso educativo; Renal replacement therapy modality choice; Tratamiento conservador.

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