CoChat
Sign Up
Cited by 457Dialysis and Renal Disease ManagementPalliative Care and End-of-Life IssuesChronic Kidney Disease and Diabetes

The DOI matches its Crossref record; 40 of the 40 references it cites were found in a registry or an index.

Is Maximum Conservative Management an Equivalent Treatment Option to Dialysis for Elderly Patients with Significant Comorbid Disease?

Open access
Carson, Rachel C., Juszczak, Maciej, Davenport, Andrew, Burns, Aine·2009·Clinical Journal of the American Society of Nephrology
DOI 10.2215/cjn.00510109PMC PMC2758251
Open this paper in CoChat — free account

Abstract

BACKGROUND AND OBJECTIVES: There is ongoing growth of elderly populations with ESRD in Western Europe and North America. In our center, we offer an alternative care pathway of 'maximum conservative management' (MCM) to patients who elect not to start dialysis, often because of a heavy burden of comorbid illness and advanced age. The objective of our study was to compare clinical outcomes for patients who had ESRD and chose either MCM or renal replacement therapy (RRT). DESIGN, SETTING, PARTICIPANTS, & MEASUREMENTS: This is an observational study of a single-center cohort in the United Kingdom that evaluating 202 elderly (> or =70 yr) patients who had ESRD and had chosen either MCM (n = 29) or RRT (n = 173). We report survival, hospitalization rates, and location of death for this cohort. Survival was measured from a standardized 'threshold' estimated GFR of 10.8 ml/min per 1.73 m(2). RESULTS: Median survival, including the first 90 d, was 37.8 mo (range 0 to 106 mo) for RRT patients and 13.9 mo (range 2 to 44) for MCM patients (P < 0.01). RRT patients had higher rates of hospitalization (0.069 [95% confidence interval (CI) 0.068 to 0.070]) versus 0.043 [95% CI 0.040 to 0.047] hospital days/patient-days survived) compared with MCM patients. MCM patients were significantly more likely to die at home or in a hospice (odds ratio 4.15; 95% CI 1.67 to 10.25). A survey of the literature describing elderly ESRD outcomes is also presented. CONCLUSIONS: Dialysis prolongs survival for elderly patients who have ESRD with significant comorbidity by approximately 2 yr; however, patients who choose MCM can survive a substantial length of time, achieving similar numbers of hospital-free days to patients who choose hemodialysis.

Overview

The claims and statistics of this paper haven’t been checked yet.

Run the check — free, no account needed. It reads the open-access text and checks the sources it cites.

A few free checks a day · papers already verified open instantly · results are public

Integrity signals

Registry

Crossref · 10.2215/cjn.00510109

Cites

40 of 40 references verified0 citation errors · 0 not checkable

Statistics

Verification

Claims the paper makes

The claims and statistics of this paper haven’t been checked yet.

Run the check — free, no account needed. It reads the open-access text and checks the sources it cites.

A few free checks a day · papers already verified open instantly · results are public

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?

Self-check

Percentages, sums and reported differences re-computed from the paper’s own numbers.

The self-check needs the paper’s full text.

Citations

Cites

Research works printed but not linked: 1

  1. Collins, 2008, Excerpts from the United States Renal Data System 2007 annual data report: Emerging issues, Am J Kidney Dis, 51, S33, 10.1053/j.ajkd.2007.11.001 · DOI

Cited by

Sorted by citations

See all 457

Related

See all

Metadata

Authors
Carson, R. C., Juszczak, M., Davenport, A., & Burns, A.
Affiliations
The Royal Free Hospital (GB)
Corresponding author
Carson, Rachel C.
ORCID
Venue
Clinical Journal of the American Society of Nephrology
Publisher
Ovid Technologies (Wolters Kluwer Health)
Published
2009-10
Volume
4
Issue
10
Pages
1611-1619
ISSN
1555-9041 (ISSN-L)
DOI
10.2215/cjn.00510109
PMC
PMC2758251
OpenAlex
W2120777698
Cited by
457
References
40
Citations by year
2026: 15 · 2025: 6 · 2024: 14 · 2023: 18 · 2022: 23 · 2021: 25 · 2020: 13 · 2019: 22 · 2018: 34 · 2017: 36 · 2016: 35 · 2015: 51 · 2014: 36 · 2013: 46 · 2012: 41
FWCI
18.83
Type
journal article
Language
en
Open access
Locations
  • Clinical Journal of the American Society of Nephrology (publishedVersion)
  • PubMed Central (publishedVersion)
  • PubMed (publishedVersion)
  • UCL Discovery (University College London) (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
end-stage renal disease, elderly patients, dialysis, renal replacement therapy, comorbidities, survival, hospitalization, place of death, hospice, hemodialysis, end-of-life care
MeSH terms
Aged, Aged, 80 and over, Female, Glomerular Filtration Rate, Renal Dialysis, Hospitalization, Humans, Kidney Failure, Chronic, Male, Comorbidity, Renal Replacement Therapy

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