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

Kurylovich K.A., Komissarov K.S., Krasko O.V.

1) Institute for Advanced Training and Retraining of Healthcare Personnel, Belarusian State Medical University, Minsk, Republic of Belarus; 2) 1st City Clinical Hospital, Minsk, Republic of Belarus; 3) Minsk Scientific and Practical Center for Surgery, Transplantology and Hematology, Minsk, Republic of Belarus; 4) United Institute of Informatics Problems of the National Academy of Sciences of Belarus, Minsk, Republic of Belarus

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).

Keywords

About the Authors

Kristina A. Kurylovich – Postgraduate Student at the Department of Urology and Nephrology, Institute of Advanced Training and Retraining of Healthcare Personnel, Belarusian State Medical University. Address: Bldg. 3, 3 P. Brovka st., Minsk, 220013 st.; Nephrologist, Hemodialysis Department, 1st City Clinical Hospital.
Address: 64 Independence Ave., Minsk, 220013; tel.: +(375 44) 740-32-95; e-mail: khruns89@gmail.com. ORCID: https://orcid.org/0000-0002-9112-4863.
Kirill S. Komissarov – Cand.Sci. (Med.), Associate Professor, Head of the Department of Nephrology, Renal Replacement Therapy and Kidney Transplantation, Minsk Scientific and Practical Center for Surgery, Transplantology and Hematology. Address: 8 Semashko st., Minsk, 220087; tel. +(37517) 277-20-35, +(375 29) 680-70-97;
e-mail: kirill_ka@tut.by. ORCID: http://orcid.org/0000-0002-2648-0642.
Olga V. Krasko – Cand. Sci. (Tech), Leading Researcher at the Laboratory of Bioinformatics, United Institute of Informatics Problems of the National Academy of Sciences of Belarus. Address: 6 Surganov st., Minsk, 220012; tel.: +(375 29) 707-88-03; e-mail: krasko@newman/bas-net.by. ORCID: https://orcid.org/0000-0002-4150-282X.

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