Prognostic value of the Charlson comorbidity index in patients aged 60 years and older starting chronic dialysis treatment

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Abstract

Objective. Evaluation of the prognostic role of the Charlson comorbidity index (CCI) as a predictor of fatal outcome in a cohort of patients ≥60 years old with stage 5 chronic kidney disease (stage 5 CKD).

Material and methods. Analysis of data from 246 patients ≥60 years old with stage 5 CKD.

Results. A univariate analysis was performed, predictors of fatal outcome: age ≤65 years, CCI >5 points, diuresis ≤350 ml/day, presence of hyperhydration, predialysis creatinine levels (pdCr) ≤514 µmol/l, predialysis urea levels (pdU) >44 mmol/l, glomerular filtration rate (GFR) according to the CKD-EPI formula ≤3.1 ml/min/1.73 m2. Multivariate analysis, predictors of fatal outcome: age >65 years (hazard ratio - HR=1.7, 95% confidence interval - CI 1.1–2.4), CCI >5 points (HR=3, 95% CI 2–4, 4), pdCr ≤514 µmol/l (HR=2.7, 95% CI 1.7–4.5) and pdU >44 mmol/l (HR=1.8, 95% CI 1.2–2, 9).

Conclusion. CCI can be used when choosing treatment tactics for patients aged ≥60 years with stage 5 CKD along with other generally accepted predictors of fatal outcome (pdCr, pdU, age).

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About the authors

Kristina A. Kurylovich

Institute for Advanced Training and Retraining of Healthcare Personnel, Belarusian State Medical University; 1st City Clinical Hospital

Author for correspondence.
Email: khruns89@gmail.com
ORCID iD: 0000-0002-9112-4863

Postgraduate Student at the Department of Urology and Nephrology, Institute of Advanced Training and Retraining of Healthcare Personnel, Belarusian State Medical University; Nephrologist, Hemodialysis Department, 1st City Clinical Hospital

Belarus, Minsk; Minsk

Kirill S. Komissarov

Minsk Scientific and Practical Center for Surgery, Transplantology and Hematology

Email: kirill_ka@tut.by
ORCID iD: 0000-0002-2648-0642

Cand.Sci. (Med.), Associate Professor, Head of the Department of Nephrology, Renal Replacement Therapy and Kidney Transplantation

Belarus, Minsk

Olga V. Krasko

United Institute of Informatics Problems of the National Academy of Sciences of Belarus

Email: kirill_ka@tut.by
ORCID iD: 0000-0002-4150-282X

Cand. Sci. (Tech), Leading Researcher at the Laboratory of Bioinformatics

Belarus, Minsk

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Supplementary files

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2. Fig. 1. The cohort of the study

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3. Fig. 2. Distribution of ICF in patients >60 years old starting treatment with chronic dialysis

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4. Fig. 3. Cumulative survival of the study cohort

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