Characteristics of Patients Involved With the Kidney Supportive Care Program: A Cohort Study of Routinely Collected Data
4 affiliations
- 1Department of Renal Medicine, Royal North Shore Hospital, New South Wales, Australia; Renal and Metabolic Division, The George Institute for Global Health, The University of New South Wales, New South Wales, Australia
- 2Northern Clinical School, Faculty of Medicine and Health, The University of Sydney, New South Wales, Australia
- 3Department of Renal Medicine, Royal North Shore Hospital, New South Wales, Australia; Northern Clinical School, Faculty of Medicine and Health, The University of Sydney, New South Wales, Australia
- 4Department of Renal Medicine, Royal North Shore Hospital, New South Wales, Australia; Sydney Clinical Trials Centre, Faculty of Medicine and Health, The University of Sydney, New South Wales, Australia
Abstract
Rationale & Objective: People with kidney failure face a significantly higher risk of death and symptom burden. We sought insights into the survival and symptom burden of people receiving medical management of kidney failure without dialysis. Study Design: Retrospective cohort study. Setting & Participants: People with an estimated glomerular filtration rate (eGFR) ≤ 15 mL/min/1.73 m 2 receiving nondialytic/conservative/palliative management and known to the Kidney Supportive Care Team in a tertiary care hospital. Predictors: eGFR at cohort entry, living arrangement, and history of ischemic heart disease, heart failure, or stroke, according to routine care databases. Outcomes: Primary: median survival. Secondary: number of hospitalizations and symptom burden assessed through the Integrated Palliative Care Outcome Scale-Renal score. Analytical Approach: Cox regression survival modeling and descriptive statistics for hospitalizations and symptom burden. Results: The cohort included 223 people receiving care between January 2016 and April 2023, with a median age of 84 (interquartile range, 77-87) years. Median survival was 452 days (95% CI, 351-552). People with an eGFR of 11-15 mL/min/1.73 m 2 at cohort entry had a median survival of 517 days (95% CI, 406-623); those with an eGFR of 6-10 mL/min/1.73 m 2 had a median survival of 260 days (95% CI, 138-382), whereas people with an eGFR of < 5 mL/min/1.73 m 2 had a median survival of 61 days (95% CI, 46-107). People living independently at home had significantly higher median survival (538 days), compared with assisted living at home (356 days) or living in a nursing home (232 days) ( P < 0.05). The studied comorbidities were not predictive of survival. At year 1, the most prevalent symptom was weakness (60%) with median “moderate” severity, with similar findings at year 2. Limitations: Single-center, retrospective study with univariable analysis. Conclusions: The study provided valuable insights into life expectancy and symptom burden with kidney failure managed without dialysis, including the prognostic value of considering the baseline living situation in anticipating survival, to help guide clinicians facing the uncertainty of this clinical scenario. Plain Language Summary: This study explored the outcomes of people with kidney failure managed without dialysis in a single Australian center through medical records. The study was undertaken to improve knowledge about survival expectations and symptom burden in people with kidney failure. In this study, survival varied between individuals, but half of the participants survived for 15 months. People with better kidney function tended to live longer, as did people living at home independently compared with people requiring living assistance or residing in a care facility. The most common symptom seen was weakness, affecting 6 out of every 10 people. The data from the study will enable us to have more informed conversations with people who are approaching kidney failure and their families.
Related
- Monitoring Emergency Medical Services Frequent Use: Protocol for a Mixed-Methods Study Using Routinely-Collected Data
- Measuring mild cognitive impairment using routinely collected health-care data: A conceptual framework and guidance for embedded pragmatic clinical trials.
- Identifying Mild Cognitive Impairment from Routinely Collected Physical, Functional and Psychosocial Measures in Community-Dwelling Older Adults: A Comparative Machine-Learning and Regression Modelling Study in the Northern Japanese ORANGE Registry.
- People living with multiple long-term conditions have different pathways of unscheduled care in hospital: findings from an analysis of routinely-collected clinical data
- Machine Learning-Supported Efficient VTE Risk Assessment using Routinely Collected Electronic Health Record Data
BibTeX
@article{jeyaruban2026characteristics,
title = {{Characteristics of Patients Involved With the Kidney Supportive Care Program: A Cohort Study of Routinely Collected Data}},
author = {Andrew Jeyaruban and Sarah A. Roxburgh and Sara J. Rendo and Daniel V. O’Hara},
journal = {Kidney Medicine},
year = {2026},
month = jul,
doi = {10.1016/j.xkme.2026.101470},
url = {https://doi.org/10.1016/j.xkme.2026.101470},
note = {CC BY},
}
RIS
TY - JOUR
TI - Characteristics of Patients Involved With the Kidney Supportive Care Program: A Cohort Study of Routinely Collected Data
AU - Andrew Jeyaruban
AU - Sarah A. Roxburgh
AU - Sara J. Rendo
AU - Daniel V. O’Hara
PY - 2026
DA - 2026/07/15
JO - Kidney Medicine
DO - 10.1016/j.xkme.2026.101470
UR - https://doi.org/10.1016/j.xkme.2026.101470
AB - Rationale & Objective: People with kidney failure face a significantly higher risk of death and symptom burden. We sought insights into the survival and symptom burden of people receiving medical management of kidney failure without dialysis. Study Design: Retrospective cohort study. Setting & Participants: People with an estimated glomerular filtration rate (eGFR) ≤ 15 mL/min/1.73 m 2 receiving nondialytic/conservative/palliative management and known to the Kidney Supportive Care Team in a tertiary care hospital. Predictors: eGFR at cohort entry, living arrangement, and history of ischemic heart disease, heart failure, or stroke, according to routine care databases. Outcomes: Primary: median survival. Secondary: number of hospitalizations and symptom burden assessed through the Integrated Palliative Care Outcome Scale-Renal score. Analytical Approach: Cox regression survival modeling and descriptive statistics for hospitalizations and symptom burden. Results: The cohort included 223 people receiving care between January 2016 and April 2023, with a median age of 84 (interquartile range, 77-87) years. Median survival was 452 days (95% CI, 351-552). People with an eGFR of 11-15 mL/min/1.73 m 2 at cohort entry had a median survival of 517 days (95% CI, 406-623); those with an eGFR of 6-10 mL/min/1.73 m 2 had a median survival of 260 days (95% CI, 138-382), whereas people with an eGFR of < 5 mL/min/1.73 m 2 had a median survival of 61 days (95% CI, 46-107). People living independently at home had significantly higher median survival (538 days), compared with assisted living at home (356 days) or living in a nursing home (232 days) ( P < 0.05). The studied comorbidities were not predictive of survival. At year 1, the most prevalent symptom was weakness (60%) with median “moderate” severity, with similar findings at year 2. Limitations: Single-center, retrospective study with univariable analysis. Conclusions: The study provided valuable insights into life expectancy and symptom burden with kidney failure managed without dialysis, including the prognostic value of considering the baseline living situation in anticipating survival, to help guide clinicians facing the uncertainty of this clinical scenario. Plain Language Summary: This study explored the outcomes of people with kidney failure managed without dialysis in a single Australian center through medical records. The study was undertaken to improve knowledge about survival expectations and symptom burden in people with kidney failure. In this study, survival varied between individuals, but half of the participants survived for 15 months. People with better kidney function tended to live longer, as did people living at home independently compared with people requiring living assistance or residing in a care facility. The most common symptom seen was weakness, affecting 6 out of every 10 people. The data from the study will enable us to have more informed conversations with people who are approaching kidney failure and their families.
SN - 2590-0595
ER -