Impact of risk factors on functional status in maintenance hemodialysis patients
Abstract Objectives To survey by measuring patient’s functional status which is crucial when end-stage renal disease patients begin a dialysis program. The influence of the disease on patients can be examined by the measurement of Karnofsky Performance Status (KPS) scores, together with a quality of...
| Main Authors: | , , , , , |
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| Format: | Article |
| Language: | English |
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BMC
2017-12-01
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| Series: | European Journal of Medical Research |
| Subjects: | |
| Online Access: | http://link.springer.com/article/10.1186/s40001-017-0298-1 |
| _version_ | 1819117365813575680 |
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| author | Jin-Bor Chen Wen-Chin Lee Ben-Chung Cheng Sin-Hua Moi Cheng-Hong Yang Yu-Da Lin |
| author_facet | Jin-Bor Chen Wen-Chin Lee Ben-Chung Cheng Sin-Hua Moi Cheng-Hong Yang Yu-Da Lin |
| author_sort | Jin-Bor Chen |
| collection | DOAJ |
| description | Abstract Objectives To survey by measuring patient’s functional status which is crucial when end-stage renal disease patients begin a dialysis program. The influence of the disease on patients can be examined by the measurement of Karnofsky Performance Status (KPS) scores, together with a quality of life survey, and clinical variables. Methods The details for the dataset in the study were collected from patients receiving regular hemodialysis (HD) in one hospital, which were available retrospectively for 1166 patients during the 5-year study period. KPS scores were applied for quantifying functional status. To identify risk factors for functional status, clinical factors including demographics, laboratory data, and HD vintage were selected. This study applied a classification and regression tree approach (CART) and logistic regression to determine risk factors on functional impairment among HD patients. Results Ten risk factors were identified by CART and regression model (age, primary kidney disease subclass, treatment years, hemoglobin, albumin, creatinine, phosphorus, intact parathyroid hormone, ferritin, and cardiothoracic ratio). The results of logistic regression with selected interaction models showed older age or higher hematocrit, blood urea nitrogen, and glucose levels could significantly increase the log-odds of obtaining low KPS scores at in-person visits. Conclusions In interaction results, the combination of older age with higher albumin level and higher creatinine level with longer HD treatment years could significantly decrease the log-odds of a low KPS score assessment during in-person visits. Age, hemoglobin, albumin, urea, creatinine levels, primary kidney disease subclass, and HD duration are the major determinants for functional status in HD patients. |
| first_indexed | 2024-12-22T05:31:50Z |
| format | Article |
| id | doaj.art-67eb45434824410691bd3d04a7326784 |
| institution | Directory Open Access Journal |
| issn | 2047-783X |
| language | English |
| last_indexed | 2024-12-22T05:31:50Z |
| publishDate | 2017-12-01 |
| publisher | BMC |
| record_format | Article |
| series | European Journal of Medical Research |
| spelling | doaj.art-67eb45434824410691bd3d04a73267842022-12-21T18:37:27ZengBMCEuropean Journal of Medical Research2047-783X2017-12-012211810.1186/s40001-017-0298-1Impact of risk factors on functional status in maintenance hemodialysis patientsJin-Bor Chen0Wen-Chin Lee1Ben-Chung Cheng2Sin-Hua Moi3Cheng-Hong Yang4Yu-Da Lin5Division of Nephrology, Department of Internal Medicine, Kaohsiung Chang Gung Memorial Hospital and Chang Gung University College of MedicineDivision of Nephrology, Department of Internal Medicine, Kaohsiung Chang Gung Memorial Hospital and Chang Gung University College of MedicineDivision of Nephrology, Department of Internal Medicine, Kaohsiung Chang Gung Memorial Hospital and Chang Gung University College of MedicineDepartment of Electronic Engineering, National Kaohsiung University of Applied SciencesDepartment of Electronic Engineering, National Kaohsiung University of Applied SciencesDepartment of Electronic Engineering, National Kaohsiung University of Applied SciencesAbstract Objectives To survey by measuring patient’s functional status which is crucial when end-stage renal disease patients begin a dialysis program. The influence of the disease on patients can be examined by the measurement of Karnofsky Performance Status (KPS) scores, together with a quality of life survey, and clinical variables. Methods The details for the dataset in the study were collected from patients receiving regular hemodialysis (HD) in one hospital, which were available retrospectively for 1166 patients during the 5-year study period. KPS scores were applied for quantifying functional status. To identify risk factors for functional status, clinical factors including demographics, laboratory data, and HD vintage were selected. This study applied a classification and regression tree approach (CART) and logistic regression to determine risk factors on functional impairment among HD patients. Results Ten risk factors were identified by CART and regression model (age, primary kidney disease subclass, treatment years, hemoglobin, albumin, creatinine, phosphorus, intact parathyroid hormone, ferritin, and cardiothoracic ratio). The results of logistic regression with selected interaction models showed older age or higher hematocrit, blood urea nitrogen, and glucose levels could significantly increase the log-odds of obtaining low KPS scores at in-person visits. Conclusions In interaction results, the combination of older age with higher albumin level and higher creatinine level with longer HD treatment years could significantly decrease the log-odds of a low KPS score assessment during in-person visits. Age, hemoglobin, albumin, urea, creatinine levels, primary kidney disease subclass, and HD duration are the major determinants for functional status in HD patients.http://link.springer.com/article/10.1186/s40001-017-0298-1HemodialysisFunctional statusKarnofsky Performance StatusClassification and regression tree approach |
| spellingShingle | Jin-Bor Chen Wen-Chin Lee Ben-Chung Cheng Sin-Hua Moi Cheng-Hong Yang Yu-Da Lin Impact of risk factors on functional status in maintenance hemodialysis patients European Journal of Medical Research Hemodialysis Functional status Karnofsky Performance Status Classification and regression tree approach |
| title | Impact of risk factors on functional status in maintenance hemodialysis patients |
| title_full | Impact of risk factors on functional status in maintenance hemodialysis patients |
| title_fullStr | Impact of risk factors on functional status in maintenance hemodialysis patients |
| title_full_unstemmed | Impact of risk factors on functional status in maintenance hemodialysis patients |
| title_short | Impact of risk factors on functional status in maintenance hemodialysis patients |
| title_sort | impact of risk factors on functional status in maintenance hemodialysis patients |
| topic | Hemodialysis Functional status Karnofsky Performance Status Classification and regression tree approach |
| url | http://link.springer.com/article/10.1186/s40001-017-0298-1 |
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