Couchoud C, et al. - Patients with chronic respiratory disease (CRD) and end-stage renal disease were characterized in this study. Additionally, researchers assessed the outcomes of these patients after dialysis start, compared with patients without CRD, focusing especially on causes of death, access to renal transplantation and causes of hospital admissions. Findings demonstrated an association of CRD with higher risks of death and hospital admissions and with lower likelihoods of being wait-listed for and undergoing renal transplantation. Data suggested that increasing clinical awareness by patients and doctors and encouragement of spirometry use should promote more accurate clinical diagnosis and better preventive care for CRD.

Methods

• A total of 52 797 adults aged 18 years and older who began dialysis from 2008 to 2013 and are recorded in the French national REIN registry, were included in this study.
• Researchers analyzed survival, specific mortality and access to the waiting list and to renal transplantation, adjusting for various comorbidities and considering competitive risks.
• Via an indirect link between the REIN database and the national French hospital discharge database, the numbers of hospitalizations and hospital days, together with their causes, were analyzed.

Results

• Findings reported that the frequency of CRD at dialysis start was 12% and was related to various other comorbidities, including obesity and tobacco use.
• An association of CRD with a higher risk of death was evident even after adjusting for those comorbidities [hazard ratio (HR) 1.20, 95% confidence interval (CI) 1.16–1.25].
• Researchers noted that patients with CRD vs those without CRD were 30% less likely to undergo transplantation (HR 0.67, 95% CI 0.6–0.7).
• These patients had 8.8 times higher risk of dying from a respiratory disease and their risk of dying from infection was also higher.
• In addition, a higher rate of admissions and more hospital days were documented in patients with CRD, for all causes and for every cause, except cancer.