Derrett et al reported factors impacting health deterioration of an adult on dialysis for at least 1 year. These can help to identify a patient who may require more aggressive management. The authors are from the University of Otago, University of Auckland, and affiliated hospitals in New Zealand.
Patient selection: adult on renal dialysis for 12 months
Predictors of health deterioration:
(1) greater social dissatisfaction (RR 1.7)
(2) lower sense of community (RR 1.7)
(3) comorbid conditions (RR 1.7)
(4) anxiety or depression (OR 1.6)
(5) fair to poor overall general health (RR 1.6, which overlaps with comorbid conditions)
(6) longer time on dialysis (RR 1.03)
Factors associated with better health status:
(1) Pacific ethnicity (RR 0.6)
(2) greater bother on the end-stage kidney symptom score at baseline (RR 0.8)
(3) hemodialysis at home (RR 0.6)
No single item is predictive.
