Incidence, prevalence, and outcomes of end-stage renal disease patients placed in nursing homes.

We prospectively surveyed the 156 dialysis centers in Network 5 (MD, VA, WV, DC) for end-stage renal disease (ESRD) patients admitted to or begun on dialysis in nursing homes during a 21-month period (April 1, 1990 to December 31, 1991). In addition to this incidence data, information on patient demographics, social characteristics, pre-existent illnesses, and functional capacity (measured by activity of daily living [ADL] scores) was obtained. One hundred thirty-two centers (close to 90% of Network 5's approximately 9,000 patients) responded to the survey. Outcome data were gathered throughout the 21-month period and the subsequent 5 months. Seventy-three centers dialyzed 228 such patients during the 18-month period. Five centers that were located in the same building as a nursing home cared for 67 patients. The 228 patients, aged 17 to 101 years, were older (65.50 years +/- 14.2 [SD] v 53.7 +/- 16.4 years), and disproportionately female (62.2% v 48.3%), white (46.5% v 37.4%), and diabetic (57.9% v 29%) compared with the general network ESRD population (P < 0.05). On admission to the nursing home 47% of patients had organic heart disease, 35% had an organic brain syndrome, 22% had cerebrovascular diseases, 19% had amputations, and 18% were blind. The mean admission ADL score was 8.1 +/- 5.2 (maximum function, 18) and the patients did not differ regarding age, sex, race, or diabetes. Forty-three percent of patients lived alone or in sheltered housing before being placed in the nursing home.(ABSTRACT TRUNCATED AT 250 WORDS)