The American Journal of Medicine
Volume 108, Issue 8 , Pages 609-613 , June 2000

A simple comorbidity scale predicts clinical outcomes and costs in dialysis patients

  • Srinivasan Beddhu, MBBS

      Affiliations

    • Renal-Electrolyte Division, Department of Medicine, University of Pittsburgh School of Medicine, Pittsburgh, Pennsylvania, USA
  • ,
  • Frank J Bruns, MD

      Affiliations

    • Renal-Electrolyte Division, Department of Medicine, University of Pittsburgh School of Medicine, Pittsburgh, Pennsylvania, USA
  • ,
  • Melissa Saul, MS

      Affiliations

    • Renal-Electrolyte Division, Department of Medicine, University of Pittsburgh School of Medicine, Pittsburgh, Pennsylvania, USA
  • ,
  • Patricia Seddon, MSN

      Affiliations

    • Renal-Electrolyte Division, Department of Medicine, University of Pittsburgh School of Medicine, Pittsburgh, Pennsylvania, USA
  • ,
  • Mark L Zeidel, MD

      Affiliations

    • Renal-Electrolyte Division, Department of Medicine, University of Pittsburgh School of Medicine, Pittsburgh, Pennsylvania, USA
    • Corresponding Author InformationRequests for reprints should be addressed to Mark L. Zeidel, MD, Renal-Electrolyte Division, Room 931 Scaife Hall, University of Pittsburgh School of Medicine, 3550 Terrace Street, Pittsburgh, Pennsylvania 15261

Received 2 February 1999 ,Revised 19 January 2000 ,Accepted 19 January 2000.

References 

  1. 1997 Annual Data Report. Bethesda, Md: National Institutes of Health, National Institute of Diabetes and Digestive and Kidney Diseases; April 1997:21–34;tables Al,B3.
  2. Hull AR. The legislative and regulatory process in the end-stage renal disease program, 1973 through 1997. Semin Nephrol. 1997;17:160–169
  3. Cooper BS, Eggers PW, Edington BM. Development of an end-stage renal disease managed care demonstration. Advance Renal Replace Ther. 1997;4:332–339
  4. Keane WF, Collins AJ. Influence of comorbidity on mortality and morbidity in patients treated with hemodialysis. Am J Kidney Dis. 1994;24:1010–1018
  5. Shapiro FL, Umen A. Risk factors in hemodialysis patient survival. ASAIO J. 1983;6:176–184
  6. Plough AL, Schwartz M, Salem SR, et al.  Severity analysis in ESRD (a risk group approach). ASAIO J. 1985;8:33–40
  7. Pollack VE, Pesce A, Kant KS. Continuous quality improvement in chronic disease (a computerized medical record enables description of severity index to evaluate outcomes in ESRD). Am J Kidney Dis. 1992;19:514–522
  8. Bruns FJ, Seddon P, Saul M, Zeidel ML. The cost of caring for end-stage kidney disease patients (an analysis based on hospital financial transaction records). J Am Soc Nephrol. 1998;9:884–890
  9. Charlson ME, Pompei P, Ales AL, MacKenzie CR. A new method of classifying prognostic comorbidity in longitudinal studies (development and validation). J Chron Dis. 1987;40:373–383
  10. Held PJ, Port FK, Gaylin DS, et al.  Comorbid conditions and correlations with mortality risk among 3,399 incident hemodialysis patients. Am J Kidney Dis. 1992;5(suppl 2):32–38
  11. Habach G, Bloembergen WE, Mauger EA, et al.  Hospitalization among United States dialysis patients (hemodialysis versus peritoneal dialysis). J Am Soc Nephrol. 1995;5:1940–1948
  12. United States Renal Data System 1992 Annual Report. Bethesda, Md: National Institutes of Health; publication no 92–3176, October 1992.
  13. United States Renal Data System 1997 Annual Report. Bethesda, Md: National Institutes of Health, National Institute of Diabetes and Digestive and Kidney Diseases; April 1997:143–161.
  14. Steinman TI. Managed care, capitation and the future of nephrology. J Am Soc Nephrol. 1997;8:1618–1623
  15. Bodenheimer T. The Oregon Health Plan. Lessons for the nation. NEJM. 1997;37:720–723
  16. Hutchinson T, Michaud L, Thomas DC. Comparing survival of patients on dialysis and after renal transplantation. ASAIO J. 1982;8:18–21
  17. Greenfield S, Sullivan L, Silliman RA, et al.  Principles and practice of case mix adjustment (applications to end-stage renal disease). Am J Kidney Dis. 1994;24:298–307
  18. Kurtin P, Nissenson AR. Variation in end-stage renal disease patient outcomes (what we know, what should we know, and how to find it out?). J Am Soc Nephrol. 1993;3:1738–1747
  19. Nicolucci A, Cubasso D, Labbrozzi D, et al.  Effect of coexistent diseases on survival of patients undergoing dialysis. ASAIO J. 1992;38:M291–M295
  20. McClellan WM, Anson C, Birkelli K, Tuttle E. Functional status and quality of life (predictors of early mortality among patients entering treatment for end-stage renal disease). J Clin Epidemiol. 1991;44:83–89
  21. Owen WF, Lew NL, Liu Y, et al.  The urea reduction ratio and serum albumin concentration as predictors of mortality in patients undergoing hemodialysis. NEJM. 1993;329:1001–1006
  22. Foley RN, Parfery PS, Harnett JD, et al.  Impact of hypertension on cardiomyopathy, morbidity and mortality in end-stage renal disease. Kidney Int. 1996;49:1379–1385
  23. National Kidney Foundation . NKF-DOQI clinical practice guidelines for hemodialysis adequacy. Am J Kidney Dis. 1997;30(suppl 2):515–566

 Supported by a grant from Dialysis Clinic, Inc. Nashville, Tennessee. Srinivasan Beddhu was recipient of a grant from the Emma Samuel Winters Foundation.

PII: S0002-9343(00)00371-5

The American Journal of Medicine
Volume 108, Issue 8 , Pages 609-613 , June 2000