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https://www.readbyqxmd.com/read/28748892/clinical-profile-of-geriatric-acute-kidney-injury-in-a-tertiary-care-center-from-south-india
#1
Eshwarappa Mahesh, Praveen Nallamuthu, Mahesh Kumar, Parampalli Rakesh Madhyastha, Gurudev Konanna
The incidence of acute kidney injury (AKI) is high in the elderly, who comprise an ever-growing segment of the population. Elderly patients pose a different set of diagnostic and therapeutic challenge owing to their associated comorbidities. AKI in the elderly is associated with an increased risk of mortality, morbidity, prolonged length of stay, and progression to chronic kidney disease. Data regarding the clinical profile of AKI in the elderly from the South Indian population are limited. Hence, we present this analysis of the etiological and prognostic factors associated with AKI in elderly population from South India...
July 2017: Saudi Journal of Kidney Diseases and Transplantation
https://www.readbyqxmd.com/read/28748884/association-between-age-and-cardiovascular-status-by-echosonography-in-asymptomatic-predialysis-patients-with-chronic-kidney-disease
#2
Biserka Tirmenstajn-Jankovic, Nada Dimkovic, Zoran Radojicic, Dusan Bastac, Milenko Zivanovic, Svetlana Zikic
Age is an important risk factor for cardiovascular disease in the general population and in dialysis patients. The aim of this study is to investigate the influence of age on the cardiovascular status of asymptomatic predialysis patients with chronic kidney disease (CKD). Echocardiography and carotid ultrasound were performed in 61 patients with CKD stages 4-5, who were divided by age into two groups: group 1 (≥65 years, n = 31) and group 2 (<65 years, n = 30). Data were compared with those of control group (≥65 years, n = 20)...
July 2017: Saudi Journal of Kidney Diseases and Transplantation
https://www.readbyqxmd.com/read/28748880/incident-elderly-patients-on-peritoneal-dialysis-epidemiological-characteristics-and-modality-impact-on-survival-time
#3
Marcia R G Franco, Marcus G Bastos, Abdul R Qureshi, Alyne Schreider, Kleyton de Andrade Bastos, Jose C Divino-Filho, Natalia M S Fernandes
Aging of the population and the increased prevalence of diseases such as diabetes and arterial hypertension result in an increasing need of dialysis treatment. Herein we describe a cohort of elderly patients on peritoneal dialysis (PD) and assess the influence of the modality on the long-term survival. Out of a multicenter prospective cohort of 2,144 BRAZPD PD incident patients during a period from December 2004 to October 2007, 762 elderly adults, defined as patients ≥65-year-old, were eligible for the study, 413 started on automated PD (APD) and 349 on continuous ambulatory PD (CAPD)...
July 2017: Saudi Journal of Kidney Diseases and Transplantation
https://www.readbyqxmd.com/read/28748872/assessment-of-frailty-in-elderly-pre-dialysis-population-using-simple-tools
#4
REVIEW
Hatem Ali, Fatima Abdelaal, Jyoti Baharani
Prevalence of chronic kidney disease (CKD) is increasing worldwide principally among the elderly population many of whom will eventually need renal replacement therapy. The relationship between frailty and CKD in the elderly population has been recognized. However, studies concentrating on frailty in pre-dialysis patients are limited. CKD predisposes to frailty through many potential mechanisms; anemia, bone mineral disease, oxidative stress, and malnutrition which in turn lead to progression of CKD culminating in a vicious cycle...
July 2017: Saudi Journal of Kidney Diseases and Transplantation
https://www.readbyqxmd.com/read/28742145/survival-analysis-of-conservative-vs-dialysis-treatment-of-elderly-patients-with-ckd-stage-5
#5
Roman Reindl-Schwaighofer, Alexander Kainz, Michael Kammer, Alexandra Dumfarth, Rainer Oberbauer
Elderly patients represent a growing population among people suffering from ESRD. So far only limited data on actual survival benefits of elderly adults initiating dialysis have been published. Besides the high burden of preexisting comorbidities, dialysis treatment itself may be associated with a further deterioration in functional status in this population. We retrospectively analyzed the Austrian Dialysis and Transplant Registry and identified 8,622 patients who started maintenance hemodialysis after the age of 65 years between 2002 and 2009...
2017: PloS One
https://www.readbyqxmd.com/read/28741581/regret-about-the-decision-to-start-dialysis-a-cross-sectional-dutch-national-survey
#6
N Berkhout-Byrne, A Gaasbeek, M J K Mallat, T J Rabelink, S P Mooijaart, F W Dekker, M van Buren
BACKGROUND: More older patients with end-stage renal disease (ESRD) are starting dialysis. Elderly patients often prefer treatments that focus on quality of life rather than primarily extending life and a substantial group of elderly dialysis patients might regret their decision to start dialysis. Healthcare provider and patient-related factors may be involved. Our objective was to measure the percentage of patients in the Netherlands who regretted their decision to start dialysis. METHODS: Cross-sectional Dutch national survey of dialysis patients...
July 2017: Netherlands Journal of Medicine
https://www.readbyqxmd.com/read/28718072/diabetes-mellitus-following-renal-transplantation-clinical-and-pharmacological-considerations-for-the-elderly-patient
#7
REVIEW
David Langsford, Adam Steinberg, Karen M Dwyer
Post-transplant diabetes mellitus occurs in 30-50% of cases during the first year post-renal transplantation. It is associated with increased morbidity, mortality and healthcare costs. Risk factors include age and specific immunosuppression regimens. At the same time, renal transplantation is increasingly indicated in elderly (aged >65 years) patients as this proportion of older patients in the prevalent dialysis population has increased. The immune system and β cells undergo senescence and this impacts on the risk for developing post-transplant diabetes and our ability to prevent such development...
July 17, 2017: Drugs & Aging
https://www.readbyqxmd.com/read/28716855/frailty-screening-tools-for-elderly-patients-incident-to-dialysis
#8
Ismay N van Loon, Namiko A Goto, Franciscus T J Boereboom, Michiel L Bots, Marianne C Verhaar, Marije E Hamaker
BACKGROUND AND OBJECTIVES: A geriatric assessment is an appropriate method for identifying frail elderly patients. In CKD, it may contribute to optimize personalized care. However, a geriatric assessment is time consuming. The purpose of our study was to compare easy to apply frailty screening tools with the geriatric assessment in patients eligible for dialysis. DESIGN, SETTING, PARTICIPANTS, & MEASUREMENTS: A total of 123 patients on incident dialysis ≥65 years old were included <3 weeks before to ≤2 weeks after dialysis initiation, and all underwent a geriatric assessment...
July 17, 2017: Clinical Journal of the American Society of Nephrology: CJASN
https://www.readbyqxmd.com/read/28714644/-dialysis-implementation-in-elderly-patients-a-difficult-clinical-choice
#9
Silesia Da Graca, Patrick Saudan
Prevalence of elderly patients with end-stage kidney disease has increased. Implementation of dialysis does not offer a clear advantage in terms of life expectancy and quality of life compared to a conservative treatment in these patients, especially in emergency and in those with severe comorbidities. The choice between dialysis and supportive care should be based on a shared decision-making process between the patient, his family and the caregivers.
February 22, 2017: Revue Médicale Suisse
https://www.readbyqxmd.com/read/28704826/dialysis-in-the-elderly-and-impact-of-institutionalization-in-the-united-states-renal-data-system
#10
Amarpali Brar, Mary Mallappallil, Dimitre G Stefanov, David Kau, Moro O Salifu
BACKGROUND: We hypothesized that in the very elderly dialysis patients in the United States, institutionalization in nursing homes would increase mortality in addition to age alone. METHODS: Incident dialysis patients from 2001 to 2008 above the age of 70 were included. Patients above 70 were categorized into 4 groups according to age as 70-75, 76-80, 81-85, and >85 years and further divided into institutionalized and noninstitutionalized. Kaplan-Meier survival curves were plotted to assess patient survival...
July 14, 2017: American Journal of Nephrology
https://www.readbyqxmd.com/read/28699033/low-white-blood-cell-count-is-independently-associated-with-chronic-kidney-disease-progression-in-the-elderly-the-ckd-route-study
#11
Yohei Arai, Eiichiro Kanda, Soichiro Iimori, Shotaro Naito, Yumi Noda, Sei Sasaki, Eisei Sohara, Tomokazu Okado, Tatemitsu Rai, Shinichi Uchida
BACKGROUND: Elevated white blood cell (WBC) count is a well-known predictor of chronic kidney disease (CKD) progression. However, elderly patients commonly fail to develop a high WBC count in response to several diseased states and may instead present a low WBC count. Therefore, we hypothesized that low WBC count, in addition to high WBC count, is associated with CKD progression in the elderly. METHODS: We conducted a prospective cohort study using 3-year follow-up data from the CKD Research of Outcomes in Treatment and Epidemiology study...
July 11, 2017: Clinical and Experimental Nephrology
https://www.readbyqxmd.com/read/28659394/pulse-wave-velocity-is-associated-with-cognitive-impairment-in-haemodialysis-patients
#12
Eve Miller-Hodges, Neeraj Dhaun
Chronic kidney disease (CKD) is common, its prevalence increasing with age. Cognitive impairment is common in the elderly, in CKD and in those on maintenance haemodialysis. As cognitive impairment is the precursor to dementia, the identification of reversible risk factors for cognitive decline is the key to reducing dementia risk. Arterial stiffness is one such potential risk factor. It is independently associated with cardiovascular outcome in dialysis patients. Importantly, the recent demonstration of an independent association between arterial stiffness and cognitive impairment in these patients suggests that vascular stiffness might be potentially causative in the development of cognitive impairment and also be an opportune target for interventions...
July 1, 2017: Clinical Science (1979-)
https://www.readbyqxmd.com/read/28640530/how-does-age-affect-the-outcome-of-kidney-transplantation-in-elderly-recipients
#13
Flavia Neri, Lucrezia Furian, Francesco Cavallin, Matteo Ravaioli, Cristina Silvestre, Paola Donato, Gaetano La Manna, Antonio Daniele Pinna, Paolo Rigotti
The aging of the on-dialysis population raises the issue of whether to propose elderly patients for kidney transplantation and how to manage their immunosuppression. This study aims to analyze the outcome of kidney transplantation on an Italian series of elderly recipients. We included in this retrospective study all patients over 60 years, receiving a deceased-donor kidney transplantation from January 2004 to December 2014 in two north Italian Centers. We analyzed the correlation of recipient age with graft's and patient's survival, delayed graft function (DGF), acute cellular rejection (ACR), surgical complications, infections and glomerular filtration rate (GFR)...
June 22, 2017: Clinical Transplantation
https://www.readbyqxmd.com/read/28635159/nutrition-in-renal-supportive-care-patient-driven-and-flexible
#14
REVIEW
Jessica Stevenson, Anthony Meade, Ann-Maree Randall, Karen Manley, Stephanie Notaras, Susan Heaney, Maria Chan, Alison Smyth, Elizabeth Josland, Frank Brennan, Mark A Brown
Renal Supportive Care is an alternative treatment pathway in advanced Chronic Kidney Disease (CKD) that is being increasingly adopted, particularly in the elderly. RSC utilises principles of palliative care and has been developed to enhance the care for dialysis patients with a high symptom burden and those being managed on a non-dialysis pathway. Nutrition management is often an under-recognised component of care, and can play an important role in improving patients' quality of life to reduce symptom burden, support physical function and independence and provide appropriate counselling to patients and their families to ensure the goals of RSC are met...
June 20, 2017: Nephrology
https://www.readbyqxmd.com/read/28620716/factors-affecting-responsiveness-to-hepatitis-b-immunization-in-dialysis-patients
#15
Ali Asan, Huriye Demirhan, Hülya Çetin Sorkun, Sevgi Özkan, Mehtap Aydın, Davut Akın, Bengü Tatar, Binali Çatak, Alper Şener, Şükran Köse
BACKGROUND: Hepatitis B virus (HBV) and hepatitis C virus (HCV) infections are widespread health problems all over the world and have high morbidity and mortality. Hemodialysis patients are more frequently exposed to these viruses as they have poor immune system and frequently undergo parenteral interventions. The vaccination against HBV prevents infection and it has been recommended for the prevention of HBV infection in all susceptible dialysis patients. This study aimed to determine the seroprevalence of HBV and HCV infections and analyzed the factors affecting inadequate response to HBV vaccine in dialysis patients...
June 15, 2017: International Urology and Nephrology
https://www.readbyqxmd.com/read/28616343/debranching-aortic-surgery
#16
REVIEW
Manuel Alonso Pérez, José Manuel Llaneza Coto, José Antonio Del Castro Madrazo, Carlota Fernández Prendes, Mario González Gay, Amer Zanabili Al-Sibbai
Conventional open surgery still remains as the gold standard of care for aortic arch and thoracoabdominal pathology. In centers of excellence, open repair of the arch has been performed with 5% immediate mortality and a low rate of complications; however overall mortality rates are around 15%, being up to 40% of all patients rejected for treatment due to their age or comorbidities. For thoracoabdominal aortic pathology, data reported from centers of excellence show immediate mortality rates from 5% to 19%, spinal cord ischemia from 2...
May 2017: Journal of Thoracic Disease
https://www.readbyqxmd.com/read/28596151/survey-on-advance-care-planning-of-italian-outpatients-on-chronic-haemodialysis
#17
Nicola Panocchia, Giuseppe Tonnara, Roberta Minacori, Dario Sacchini, Maurizio Bossola, Luigi Tazza, Giovanni Gambaro, Antonio Gioacchino Spagnolo
OBJECTIVES: The clinical practice guidelines published by the Renal Physicians Association (USA) recommend instituting advance care planning (ACP) for patients with end-stage renal disease. Studies on this issue are lacking in Italy. Our aim was to determine the attitudes of patients on ACP in our dialysis centre. METHODS: We performed a cross-sectional survey. We recruited patients on maintenance haemodialysis (HD) at Hemodialysis Center of Università Cattolica del Sacro Cuore, from 1 March 2014 to 31 March 2015...
June 8, 2017: BMJ Supportive & Palliative Care
https://www.readbyqxmd.com/read/28583573/kidney-transplantation-in-korean-patients-with-end-stage-renal-disease-aged-65-and-older-a-single-center-experience
#18
S S Kang, W Y Park, K Jin, S B Park, S Han
BACKGROUND: The mean age of patients starting dialysis in Korea has increased to older than 60 years and the proportion of patients aged 65 and older exceeded 40% in 2014. Although the number of elderly dialysis patients is increasing rapidly, percentages of elderly patients undergoing kidney transplantation (KT) are very low. METHODS: We retrospectively reviewed the medical records of patients who underwent KT at Keimyung University Dongsan Medical Center between 1982 and 2016...
June 2017: Transplantation Proceedings
https://www.readbyqxmd.com/read/28575124/seasonal-variation-in-hemodialysis-initiation-a-single-center-retrospective-analysis
#19
Yujiro Maeoka, Takayuki Naito, Taisuke Irifuku, Yuka Shimizu, Takahiko Ogawa, Takao Masaki
The number of new dialysis patients has been increasing worldwide, particularly among elderly individuals. However, information on seasonal variation in hemodialysis initiation in recent decades is lacking, and the seasonal distribution of patients' conditions immediately prior to starting dialysis remains unclear. Having this information could help in developing a modifiable approach to improving pre-dialysis care. We retrospectively investigated the records of 297 patients who initiated hemodialysis at Hiroshima Prefectural Hospital from January 1st, 2009 to December 31st, 2013...
2017: PloS One
https://www.readbyqxmd.com/read/28558794/assessment-of-physical-activity-capacity-and-nutritional-status-in-elderly-peritoneal-dialysis-patients
#20
Adamasco Cupisti, Claudia D'Alessandro, Viviana Finato, Claudia Del Corso, Battista Catania, Gian Marco Caselli, Maria Francesca Egidi
BACKGROUND: This study aimed to evaluate the prevalence of sedentarism, and to assess physical capacity and nutritional status in a cohort of older patients on peritoneal dialysis (PD), with respect to age-matched non-dialysis CKD population, using highly accessible, simple methods, namely the Rapid Assessment of Physical activity (RAPA) test and the 30″ Sit-to-stand (STS) test. METHODS: This cross-sectional multicenter study included 151 renal patients older than 60 years; 71 pts...
May 30, 2017: BMC Nephrology
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