Nephrology Visits May Not Improve Elderly CKD Patient Survival

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ORLANDO, Fla.—Nephrology consults within two years of a diagnosis of chronic kidney disease (CKD) may not make a significant difference in survival among elderly patients, according to data presented at the National Kidney Foundation's 2013 Spring Clinical Meetings.

Mohamad Al-Abed, MD, and collaborators at Geisinger Medical Center in Danville, Pa., analyzed retrospective data of an elderly cohort (aged 66-88 years) of primary care patients with a first estimated glomerular filtration rate (eGFR) of 30-59 mL/min/1.73 m2. Of 13,724 patients meeting inclusion criteria, 556 were seen by a nephrologist within two years of study entry. A total of 3,297 patients died after study entry: 91 in the referred group and 3,206 in the control arm. After adjusting for gender, comorbidities, body mass index (BMI), statin use, proteinuria, and systolic and diastolic blood pressure, a nephrology visit did not significant affect all-cause mortality, the researchers reported.

The study revealed that elderly individuals with incident CKD who are seen by a nephrologist are relatively younger than those who are not (71.8 vs. 74.7 years), more likely to be female (63.7% vs. 41.5%), have a higher BMI (29.6 vs. 28.3 kg/m2), and have more comorbidities.

Regarding study limitations, the researchers noted that it was retrospective and conducted at a single center and included predominantly Caucasian patients.

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