Characteristics and Outcomes of Chronic Kidney Disease Patients Who Default on Appointments at a Low Clearance Clinic

A significant proportion of predialysis patients default on nephrology clinic appointments. Characteristics and implications for discontinuing predialysis care are not well understood. Our case-control study investigated the determinants of patients who defaulted at a low clearance clinic and their effects on patient outcomes. The subjects (n = 36) were those who defaulted on appointments at a low clearance clinic without a medical reason. Controls were the other 76 attendees of the clinic. Patients who defaulted were younger, had lower Charlson Co-morbidity Index scores but similar Davies scores, and were more likely to be single. In the multivariable logistic regression model, age was independently associated with the odds of defaulting (adjusted odds ratio for each 10-year increment of decreasing age was 1.44, 95% confidence interval 1.11–1.90). Cox proportional model analysis showed that age and smoking history were the only variables associated with all-cause mortality. Patient survival appeared not to be affected by the history of defaulting at the low clearance clinic. Our findings confirm that young age is the single most important independent factor for predicting the behavior of defaulting on clinic appointments.