CoChat
Sign Up
Cited by 349Dialysis and Renal Disease ManagementPalliative Care and End-of-Life IssuesChronic Kidney Disease and Diabetes

The DOI matches its Crossref record; 26 of the 27 references it cites were found in a registry or an index.

Clinical outcomes, quality of life, and costs in the North Thames Dialysis Study of elderly people on dialysis: a prospective cohort study

Lamping, Donna L, Constantinovici, Niculae, Roderick, Paul, Normand, Charles, Henderson, Lynne, Harris, Susan, Brown, Edwina, Gruen, Reinhold, Victor, Christina·2000·The Lancet
DOI 10.1016/s0140-6736(00)03123-8
Open this paper in CoChat — free account

Abstract

Background Evidence-based health policy is urgently needed to meet the increasing demand for health services among elderly people, particularly for expensive technologies such as renal-replacement therapy. Age has been used to ration dialysis, although not always explicitly, despite the lack of rigorous empirical evidence about how elderly people fare on dialysis. We undertook a comprehensive assessment of outcomes in patients 70 years or over.Methods We did a 12-month prospective cohort study of outcomes in 221 patients with end-stage renal failure aged 70 years or over recruited from four hospital-based renal units. We assessed 1-year survival in 125 incident patients (70-86 years) and disease burden (hospital admissions, quality of life, costs) in 174 prevalent patients (70-93 years).Findings 1-year survival rates were: 71% overall; 80%, 69%, and 54% in patients 70-74 years, 75-79 years, and 80 years and older, respectively (p=0.008); and 88%, 71%, and 64% in patients with no, one, or two or more comorbid conditions, respectively (p=0.056). Cox regression analyses showed that mortality was significantly associated with age 80 years and older (relative risk 2.79 [95% CI 1.28-6.93]) and peripheral vascular disease (2.83 [1.29-6.17]), but not with diabetes, ischaemic heart disease, cerebrovascular disease, chronic obstructive airways disease, sex, or treatment method. In terms of disease burden, hospital admissions represent a low proportion of costs and was not required by a third of patients, mental quality of life in elderly dialysis patients was similar to that of elderly people in the general population, and the average annual cost per patient of 20802 (US$31200) (68% dialysis treatment, 1% transport, 19% inpatient hospital admissions, 12% medications) was within the range of other life-extending interventions.Interpretation Our results suggest that age alone should not be used as a barrier to referral and treatment and emphasise the need to consider the benefits of dialysis in elderly people. Indicators of the ability to benefit from treatment, rather than chronological age, should be used to develop policies that ensure equal access to care for all.

Overview

Integrity signals

Registry

Crossref · 10.1016/s0140-6736(00)03123-8

Cites

26 of 26 references verified0 citation errors · 0 not checkable

Statistics

Recomputing p-values needs the paper’s full text.

Verification

Claims the paper makes

This paper’s full text isn’t openly available, so its claims and self-check weren’t run. The registry and citation checks still apply.

Claims other papers make about this one

Each is checked against this paper’s own text: does it say what the citing paper says it does?

Citations

Cites

Research works printed but not linked: 2

  1. 1991, Description of the USRDS and its data base, Am J Kid Dis, 18, 17
  2. Khan, 1996, Chronic renal failure: factors influencing nephrology referral and outcome, QJM, 89, 397

Cited by

Sorted by citations

See all 349

Related

See all

Metadata

Authors
Lamping, D. L., Constantinovici, N., Roderick, P., Normand, C., Henderson, L., Harris, S., Brown, E., Gruen, R., & Victor, C.
Affiliations
  • London School of Hygiene & Tropical Medicine (GB)
  • The Royal Free Hospital (GB)
  • University of Southampton (GB)
  • Charing Cross Hospital (GB)
  • St George's Hospital (GB)
Corresponding author
Lamping, Donna L
ORCID
Venue
The Lancet
Publisher
Elsevier BV
Published
2000-11
Volume
356
Issue
9241
Pages
1543-1550
ISSN
  • 0099-5355 (ISSN-L)
  • 0140-6736
DOI
10.1016/s0140-6736(00)03123-8
OpenAlex
W2122886742
Cited by
349
References
27
Citations by year
2026: 1 · 2025: 4 · 2024: 3 · 2023: 6 · 2022: 7 · 2021: 4 · 2020: 8 · 2019: 7 · 2018: 12 · 2017: 8 · 2016: 20 · 2015: 16 · 2014: 32 · 2013: 32 · 2012: 24
FWCI
5.96
Type
journal article
Language
en
Open access
closed
Licence
www.elsevier.com/tdm/userlicense/1.0/ (tdm)
Locations
  • The Lancet (publishedVersion)
  • PubMed (publishedVersion)
  • DigitalGeorgetown (Georgetown University Library) (submittedVersion)
Topics
  • Health Sciences › Medicine › Nephrology › Dialysis and Renal Disease Management
  • Health Sciences › Medicine › Public Health, Environmental and Occupational Health › Palliative Care and End-of-Life Issues
  • Health Sciences › Medicine › Nephrology › Chronic Kidney Disease and Diabetes
Keywords
elderly dialysis patients, end-stage renal disease, renal replacement therapy, survival, comorbidities, peripheral vascular disease, quality of life, hospitalization, health care costs, health policy, elderly health services, cost-effectiveness
MeSH terms
Aged, Aged, 80 and over, Female, Health Services for the Aged, Renal Dialysis, Hospitalization, Humans, Kidney Failure, Chronic, London, Male, Prospective Studies, Quality of Life, Social Class, Health Care Rationing, Comorbidity, Survival Rate, Multivariate Analysis, Treatment Outcome, Resource Allocation

About these checks

Registry, retraction, Cites and statistics results are computed, not judged, with one exception: a printed reference that no index lists is read once by a model before it counts as a citation error. Claims are extracted by a model and kept only when their quote appears verbatim in the text; each cited source is then checked, with a model’s help, for whether it says what the claim relies on. Those verdicts can be wrong — read the claim’s quote and the cited source before relying on one.

Statistics and arithmetic are recomputed, not judged.

Confidence bands are shown only for fields calibrated on our annotated test set. None is calibrated yet, so no band is shown.

What counts as a claim ›How we measure confidence ›How we check this ›

Are you an author, or do you see a problem with this page? Request a review