Abstract: FR-PO459
Risk of ESRD and Mortality in Stage 3 CKD Using a Risk Estimator
Session Information
- CKD: Risk Factors for Incidence and Progression - II
November 03, 2017 | Location: Hall H, Morial Convention Center
Abstract Time: 10:00 AM - 10:00 AM
Category: Chronic Kidney Disease (Non-Dialysis)
- 301 CKD: Risk Factors for Incidence and Progression
Authors
- Park, Youngjun, NYU-Winthrop Hospital, Mineola, New York, United States
- Chowdhury, Nawsheen, NYU-Winthrop Hospital, Mineola, New York, United States
- Grant, Candace D., NYU-Winthrop Hospital, Mineola, New York, United States
- Shirazian, Shayan, NYU-Winthrop Hospital, Mineola, New York, United States
Background
Accurate assessment of the risk of end stage renal disease (ESRD) is important in determining which patients with chronic kidney disease (CKD) to prepare for renal replacement therapy (RRT). This can be challenging in earlier CKD when the short term risk for ESRD can be low but the lifetime risk is high. We applied a short term (2-year) risk calculation method to a population of stage 3 CKD patients and carried out an observational study to assess outcomes.
Methods
This is a cross-sectional study of 409 patients with stage 3 CKD. The ESRD risk estimation was determined using the 2 year risk estimator developed and validated by Tangri et al. A 2-year risk of progression to ESRD of <2.5% was considered low risk (LR) and ≥ 2.5% was considered high risk (HR). Patients were then organized into groups by age (< 60, 60 to 79 and ≥80 years). Over the following 2 years development of ESRD and death were recorded.
Results
The average age for the entire group was 70±14 years, 68% were men, 78% were white, the mean GFR was 42 ml/min/1.73m2 and the mean 2 year ESRD risk was 2.2%. The 2 year calculator determined 76% (n=311) of our entire stage 3 cohort to be LR. None of the LR group reached ESRD versus 5% of the HR group and 5% of the LR group died versus 10% of the HR group. The 2 year risk of ESRD progressively diverged with younger age with a 4.2% risk for patients <60, versus a 1.9% and 1.1% risk for patients 60 to 79 and ≥ 80, respectively (p<0.001). For patients younger than 60, 46% of them were at high risk compared to 10% in the ≥ 80 year age group (p<0.001). We found none of the patients aged ≥ 80 versus 4% of the younger patients aged <60 years reached ESRD. In contrast, 11% of the older patients versus 4% of the younger patients died.
Conclusion
These results show that in our population age had a significant impact on 2 year estimated ESRD risk.
Risk determinations and outcomes showed progressively higher ESRD risk with younger age and a higher risk of death with older age. A validated risk calculator to assign patients to LR and HR groups appears to help predict clinical outcomes and might be a useful tool in guiding proper selection of patients for preparation for RRT.