Renal Replacement Therapy Based on Comorbid Factors

Description

Khan et al identified risk groups for patients undergoing renal replacement therapy. A patient at higher risk may benefit from more aggressive management or treatment with a novel therapy. The authors are from the University of Aberdeen, Aberdeen Royal Infirmary and Ninewells Hospital in Dundee.

Patient selection: end-stage renal disease treated by hemodialysis, continuous abdominal peritoneal dialysis or renal transplantation

Parameters:

(1) age

(2) comorbid conditions

Age in Years	Comorbid Conditions	Risk Group
> 80 years	NA	high
NA	end stage renal disease plus >= 2 organ dysfunctions	high
NA	diabetes and cardiopulmonary disease	high
NA	visceral malignancy	high
70 to 80 years	NA	medium
< 70 years	diabetes mellitus	medium
< 80 years	>= 1 comorbid conditions (see below)	medium
< 70	none	low

where:

• The medium risk group with age < 80 and >= 1 comorbid factor could be rewritten as < 70 and >= 1 comorbid factor since 70-80 already is at medium risk.

• The visceral malignancy probably should only be applied if uncontrolled. Hematologic malignancy should also confer risk.

• Should a patient with multiple medium risk criteria met be bumped up to high risk?

Comorbid conditions:

(1) angina

(2) previous myocardial infarction

(3) cardiac failure

(4) chronic obstructive airways disease

(5) pulmonary fibrosis

(6) liver disease (cirrhosis, chronic hepatitis)

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Description

Specialty

Objective

ICD-10

Renal Replacement Therapy Risk Groups Based on Comorbid Factors

Purpose: To evaluate a patient undergoing renal replacement therapy based on the risk groups of Khan et al.

Description

Specialty

Objective

ICD-10