Objectives
Chronic kidney disease (CKD) is an emerging health concern and may have important
implications for the management of older people with many other chronic conditions,
such as the nursing home (NH) resident population. This study was designed to describe
the prevalence of CKD and associated comorbidities in a representative sample of NH
residents.
Design
Cross-sectional descriptive study as a component of a prospective observational study
of CKD and anemia in the NH population.
Setting
Eighty-two geographically representative NHs in the United States.
Participants
Participants were 794 NH residents who had complete baseline data collected.
Measurements
Residents for whom consent was obtained underwent a record review focused on identifying
a predefined set of comorbid conditions, clinical assessment, and blood and urine
collections. Stage of CKD was based on estimated GFR (eGFR) using the MDRD equation:
no CKD (eGFR > 60 mL/min/1.73 m2), Stage 3a (45–59), Stage 3b (30–44), and Stage 4/5 (< 30).
Results
Consent was obtained from 847 of 1626 residents screened; 32 were ineligible and 21
dropped out of the study; complete data were available for 794 residents. CKD was
present in approximately 50% of residents; of these residents with CKD, 47.6% were
stage 3a, 39.27% stage 3b, and 13.2% stage 4/5. Fifty percent of the population had
anemia, and anemia was more common in those with CKD. The average number of comorbid
conditions in the population was 5.3 (SD 2.2); the proportion of patients with multiple
comorbid conditions, especially cardiovascular conditions, increased with increasing
stage of CKD. Among those without CKD, 57% had 5 or more comorbidities in comparison
to 87% of those with stage 4/5 CKD.
Conclusions
In this representative sample of 794 US NH residents, 50% had clinical evidence of
CKD. Patients with CKD, particularly those at later stages, were more likely to have
cardiovascular comorbidities and anemia. The co-occurrence of these conditions in
institutionalized populations may have important implications for the clinical management
of this patient population, particularly as it relates to the potential for further
renal complications.
Keywords
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Article info
Publication history
Published online: November 09, 2009
Footnotes
B.D.B., L.L., A.S., and R.K. are employees of Amgen. J.G.O. served as a paid consultant to Amgen to help design and implement the project reported in this article, and has received an educational grant from Amgen.
Identification
Copyright
© 2010 Published by Elsevier Inc.
