Merkus et al identified factors associated with poor outcome for a patient on chronic dialysis. These can help to identify a patient who may benefit from more aggressive management. The authors are from the NECOSAD (Netherlands Cooperative Study on the Adequacy of Dialysis) Study Group,
Patient selection: chronic dialysis, hemodialysis or peritoneal dialysis
Poor outcome: death. frequent hospitalizations, malnutrition, poor quality of life
Predictors of a poor outcome:
(1) significant comorbidity (comorbidity score of Davies; comorbidity score of Kahn et al)
(2) serum albumin < 30 g/L
(3) poor physical or mental quality of life
(4) residual GFR <= 2.5 mL per min per 1.73 square meters
Additional predictor for patients on peritoneal dialysis:
(1) mean arterial blood pressure > 107 mm Hg
where:
• A blood pressure of 140/90 mm Hg has a mean arterial blood pressure of 107 mm Hg
• Some of the criteria for poor outcome (serum albumin, quality of life) were found as predictors.
