The Endstage Renal Disease Severity Index (ESRD-SI) is a 6-point Likert with variable weightings that can be used to evaluate the severity of illness in a patient with end-stage renal disease. It can be used to monitor a patient over time and to evaluate response to interventions. The authors are from the University of Toronto.
Parameters based on complications or concurrent diseases:
(1) heart disease
(2) cerebral vascular disease
(3) peripheral vascular disease
(4) peripheral neuropathy
(5) bone disease
(6) respiratory disease
(7) visual impairment
(8) autonomic neuropathy and gastrointestinal disease
(9) access and dialysis events
(10) diabetes
(11) other (specify)
where:
• Most of these conditions seem to reflect diabetic complications.
Responses are on a 6-Likert scale ranging from absent to severe. Points for each organ dysfunction were assigned over the range of 0 to 10 based upon the perceived significance of the complication or coincident condition.
|
Response |
Heart Disease |
Cerebral Vascular |
Peripheral Vascular |
Peripheral Neuropathy |
|---|---|---|---|---|
|
absent |
0 |
0 |
0 |
0 |
|
mild |
3 |
5 |
3 |
2 |
|
mild to moderate |
5 |
6 |
4 |
3 |
|
moderate |
6 |
7 |
5 |
4 |
|
moderate to severe |
8 |
8 |
7 |
5 |
|
severe |
10 |
9 |
8 |
7 |
|
Response |
Bone Disease |
Respiratory Disease |
Visual Impairment |
Autonomic Neuropathy & GI Disease |
|---|---|---|---|---|
|
absent |
0 |
0 |
0 |
0 |
|
mild |
1 |
3 |
2 |
2 |
|
mild to moderate |
3 |
5 |
4 |
4 |
|
moderate |
5 |
6 |
5 |
5 |
|
moderate to severe |
7 |
8 |
6 |
7 |
|
severe |
8 |
10 |
8 |
8 |
|
Response |
Access and Dialysis Events |
Diabetes |
Other |
|---|---|---|---|
|
absent |
0 |
0 |
0 |
|
mild |
1 |
1 |
1 |
|
mild to moderate |
4 |
3 |
2 |
|
moderate |
6 |
5 |
4 |
|
moderate to severe |
7 |
7 |
6 |
|
severe |
9 |
9 |
8 |
total score =
= SUM(points for all 11 parameters)
Interpretation:
• minimum score: 0
• maximum score: 94
• The higher the score the more severe the comorbid conditions.
Performance:
• Inter-relater reliability (between 4 nephrologists) was 0.92.
• Test-retest correlation was 0.923.
• The index was compared with the Sickness Impact Profile.
• The index was found to be sensitive to factors associated with increased morbidity and mortality in dialysis patients.
Purpose: To evaluate the severity of concurrent conditions in a patient with end-stage renal disease using the ESRD severity index (ESRD-SI).
Specialty: Nephrology, Clinical Laboratory
Objective: severity, prognosis, stage
ICD-10: N17,
