Life Expectancy of Chinese Patients with Chronic Kidney Disease Without Dialysis

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Life Expectancy of Chinese Patients with Chronic Kidney Disease Without Dialysis
Cheuk-Chun SZETO MD, FRCP, Professor, Bonnie Ching-Ha KWAN MBBS, MRCP(UK), Associate Professor, Kai-Ming CHOW MBChB, MRCP(UK), Associate Consultant, Wing-Fai PANG MBChB, MRCP(UK), Fellow, Vickie Wai-Ki KWONG MBBS, MRCP(UK), Fellow, Chi-Bon LEUNG MBChB, FRCP(Edin), Consultant, Philip Kam-Tao LI MD, FRCP, FACP, Consultant
DOI: 10.1111/j.1440-1797.2011.01504.x

© 2011 The Authors. Nephrology © 2011 Asian Pacific Society of Nephrology
Issue
Nephrology
Accepted Article (Accepted, unedited articles published online for future issues)

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Summary at a Glance - This paper describes the survival of people with advanced chronic kidney disease managed without dialysis. It uses an anticipated start date for dialysis based on an eGFR of 7mls/min/1.73m2 and separates people based on whether they were offered dialysis and subsequently declined (declining group) or never offered due to comorbidities (conservative group). The timing and cause of death from first assessment is described, providing better information for people treated without dialysis.
This is an Accepted Article that has been peer-reviewed and approved for publication in the Nephrology, but has yet to undergo copy-editing and proof correction. Please cite this article as an “Accepted Article”; doi: 10.1111/j.1440-1797.2011.01504.x

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Keywords:
survival;renal failure;uremia
ABSTRACT
Background Long term dialysis is life-saving for patients with end stage renal disease (ESRD). However, in ESRD patients with multiple comorbid conditions, dialysis may actually be futile, and conservative management is advisable. We studied the life expectancy of Chinese ESRD patients treated conservatively. Methods We reviewed 63 consecutive ESRD patients who were treated conservatively in our center. Duration of survival was computed from the date of initial assessment for dialysis, as well as the expected date of needing dialysis based on previous trend of renal function decline. Results At the end of the observation period, 55 patients died. Twelve patients died before the expected date of needing dialysis because of unrelated reasons, while 36 deaths were directly attributed to uremia. The median overall survival after initial assessment for dialysis was 41.3 months (95% confidence interval [CI], 33.2 to 49.4 months). The median overall survival was 6.58 months (inter-quartile range, 0.92 to 9.33 months) from the theoretical date of needing dialysis. The survival from the theoretical date of needing dialysis did not correlate with patient age, sex, diabetic status, or baseline renal function. Conclusions In Chinese ESRD patients treated conservatively, the median survival is around 6 months after the theoretical date of needing dialysis. Our result provides an important piece of information for the decision of dialysis and patient counseling.

http://onlinelibrary.wiley.com/doi/10.1111/j.1440-1797.2011.01504.x/abstract