Journal of Clinical Medicine (Dec 2020)

Association between Multidimensional Prognostic Index and Hospitalization and Mortality among Older Adults with Chronic Kidney Disease on Conservative or on Replacement Therapy

  • Silvia Lai,
  • Maria Ida Amabile,
  • Sandro Mazzaferro,
  • Giovanni Imbimbo,
  • Anna Paola Mitterhofer,
  • Alessandro Galani,
  • Filippo Aucella,
  • Giuliano Brunori,
  • Paolo Menè,
  • Alessio Molfino,
  • The Study Group on Geriatric Nephrology of the Italian Society of Nephrology (SIN)

DOI
https://doi.org/10.3390/jcm9123965
Journal volume & issue
Vol. 9, no. 12
p. 3965

Abstract

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The prevalence of renal disease is constantly increasing in older adults and a prognostic evaluation by a valid tool may play a key role in treatment management. We aimed to assess the association(s) between the multidimensional prognostic index (MPI) and both the hospitalization and mortality among older adults with renal disease. Patients with chronic kidney disease (CKD) (stage 3–5 KDOQI) and on dialysis were considered. Clinical parameters were registered at baseline and after 2 years. In all the patients, the MPI was calculated and divided into grade 0 (low risk), 1 (moderate risk), and 2 (severe risk). Hospitalizations and mortality were recorded during the follow-up and analyzed according to MPI grade. A total of 173 patients, with a median age of 76 years, on conservative (n = 105) and replacement therapy (32 patients on hemodialysis, 36 patients on peritoneal dialysis) were enrolled. Of them, 60 patients were in MPI grade 0, 102 in grade 1, and 11 in grade 2. The median duration of all the hospitalizations was 6 days and the number of deaths was 33. MPI significantly correlated with days of hospitalization (r = 0.801, p r = 0.808, p p p p < 0.001). Our results indicate that MPI was associated with outcomes in patients with renal disease, suggesting that a multidimensional evaluation should be implemented in this clinical setting.

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