This Article  • References  • Full text PDF  • Send to a friend  • Save in My Folder  • Save to citation manager  • Permissions  Citing Articles  • Citation map  • Citing articles on HighWire  • Contact me when this article is cited  Related Content  • Similar articles in this journal  Social Bookmarking   What's this?

David G. Husebye, MD; Lars Westlie, MD; Thomas J. Styrvoky; Carl M. Kjellstrand, MD

Arch Intern Med. 1987;147(11):1921-1924.

Abstract
• We prospectively studied the influence of 29 demographic, social, psychological, and somatic factors on survival of 78 patients over age 70 years receiving long-term dialysis. Three years after the prospective evaluation, 54% of the patients had died. Only four factors, all psychosocial, were prognostically important. The patients who survived rated higher on the Karnofsky scale (85 vs 78 points), gained less weight between dialyses (1.5 vs 1.9 kg), more often underwent home dialysis (44% vs 21%), and less often wished for transplantation (28% vs 57%). In stepwise and multiple regression analysis, home dialysis and Karnofsky scale resulted in best fit. No somatic variable predicted outcome. Thirty-one patients were reinterviewed three years later. At that time, more patients were depressed and had a lower income, fewer wanted a transplant, and five had lost their living companion. There was a decrease in the number of patients who cooked their own meals, spent time outdoors, went to church, or had hobbies. Activity on the Karnofsky scale decreased from 87 to 84 points. The home dialysis patients' perceived health decreased from 3.9 to 3.4 points. Our study shows that psychosocial, but not somatic variables, are prognostically important in survival of older patients undergoing dialysis, and there is a measurable decline in these variables during a three-year follow-up period.

(Arch Intern Med 1987;147:1921-1924)

Author Affiliations
From the Nephrology Division, Department of Medicine, Hennepin County Medical Center, Minneapolis (Dr Husebye), Division of Nephrology, Central Hospital, Fredrikstad, Norway (Dr Westlie); Department of Medicine, University of Minnesota, Minneapolis (Mr Styrvoky); and Nephrology Division, Department of Medicine, Karolinska Hospital, Stockholm (Dr Kjellstrand).

Footnotes
Accepted for publication June 22, 1987.

Reprint requests to Nephrology Division, Department of Medicine, Karolinska Hospital, S-104 01, Stockholm, Sweden (Dr Kjellstrand).

CiteULike    Connotea    Del.icio.us    Digg    Reddit    Technorati    Twitter     What's this?

THIS ARTICLE HAS BEEN CITED BY OTHER ARTICLES

Psychosocial Aspects of Chronic Disease: ESRD as a Paradigmatic Illness
Cukor et al.
J. Am. Soc. Nephrol. 2007;18:3042-3055.
ABSTRACT | FULL TEXT  

Temporal Relation among Depression Symptoms, Cardiovascular Disease Events, and Mortality in End-Stage Renal Disease: Contribution of Reverse Causality
Boulware et al.
CJASN 2006;1:496-504.
ABSTRACT | FULL TEXT  

Depression in Patients with End-Stage Renal Disease Treated with Dialysis: Has the Time to Treat Arrived?
Kimmel and Peterson
CJASN 2006;1:349-352.
FULL TEXT  

Impact of social factors on patients on peritoneal dialysis
Chow et al.
Nephrol Dial Transplant 2005;20:2504-2510.
ABSTRACT | FULL TEXT  

Psychiatry in the renal unit
Phipps and Turkington
Adv. Psychiatr. Treat. 2001;7:426-432.
FULL TEXT  

A Prospective Study of Risk Factors and Decision Making in Discontinuation of Dialysis
Bajwa et al.
Arch Intern Med 1996;156:2571-2577.
ABSTRACT  

Variable Mortality Rates among Dialysis Treatment Centers
McClellan et al.
ANN INTERN MED 1992;117:332-336.
ABSTRACT