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Elderly dialysis

Junichi Hoshino, Takayuki Hamano, Masanori Abe, Takeshi Hasegawa, Atsushi Wada, Yoshifumi Ubara, Kenmei Takaichi, Masaaki Inaba, Shigeru Nakai, Ikuto Masakane
Background: For glycemic control in diabetic patients on dialysis it was unclear what level of glycated albumin (GA) was associated with the lowest mortality and GA's utility. Accordingly, we examined the difference in association between GA and hemoglobin A1c (HbA1c) with 1-year mortality in a cohort of the Japanese Society for Dialysis Therapy. Methods: We examined 84 282 patients with prevalent diabetes who were on maintenance hemodialysis (HD) (female 30.3%; mean age 67...
March 8, 2018: Nephrology, Dialysis, Transplantation
Jie-Qiong Liu, Guang-Yan Cai, Shuang Liang, Wen-Ling Wang, Si-Yang Wang, Fang-Lei Zhu, Sa-Sa Nie, Zhe Feng, Xiang-Mei Chen
PURPOSE OF THE STUDY: The incidence of acute kidney injury (AKI) with a poor prognosis in the elderly has been increasing each year. This study aimed to investigate the clinical characteristics of and risk factors for death from AKI in the elderly and help improve prognosis. STUDY DESIGN: This study was a retrospective cohort study based on data from adult patients (≥18 years old) admitted to 15 hospitals in China between 1 January 2009 and 31 December 2011. The characteristics of AKI in the elderly were compared with those in younger patients...
March 7, 2018: Postgraduate Medical Journal
Harmke A Polinder-Bos, David Vállez García, Johanna Kuipers, Jan Willem J Elting, Marcel J H Aries, Wim P Krijnen, Henk Groen, Antoon T M Willemsen, Peter J van Laar, Fijanne Strijkert, Gert Luurtsema, Riemer H J A Slart, Ralf Westerhuis, Ron T Gansevoort, Carlo A J M Gaillard, Casper F M Franssen
The initiation of hemodialysis is associated with an accelerated decline of cognitive function and an increased incidence of cerebrovascular accidents and white matter lesions. Investigators have hypothesized that the repetitive circulatory stress of hemodialysis induces ischemic cerebral injury, but the mechanism is unclear. We studied the acute effect of conventional hemodialysis on cerebral blood flow (CBF), measured by [15 O]H2 O positron emission tomography-computed tomography (PET-CT). During a single hemodialysis session, three [15 O]H2 O PET-CT scans were performed: before, early after the start of, and at the end of hemodialysis...
March 1, 2018: Journal of the American Society of Nephrology: JASN
Domingo Hernández, Juana Alonso-Titos, Ana María Armas-Padrón, Pedro Ruiz-Esteban, Mercedes Cabello, Verónica López, Laura Fuentes, Cristina Jironda, Silvia Ros, Tamara Jiménez, Elena Gutiérrez, Eugenia Sola, Miguel Angel Frutos, Miguel González-Molina, Armando Torres
The number of elderly patients on the waiting list (WL) for kidney transplantation (KT) has risen significantly in recent years. Because KT offers a better survival than dialysis therapy, even in the elderly, candidates for KT should be selected carefully, particularly in older waitlisted patients. Identification of risk factors for death in WL patients and prediction of both perioperative risk and long-term post-transplant mortality are crucial for the proper allocation of organs and the clinical management of these patients in order to decrease mortality, both while on the WL and after KT...
February 22, 2018: Kidney & Blood Pressure Research
Holger Eggebrecht, Kurt Bestehorn, Tienush Rassaf, Maike Bestehorn, Thomas Voigtländer, Eckhard Fleck, Volker Schächinger, Axel Schmermund, Rajendra H Mehta
AIMS: Randomised trials comparing transcatheter aortic valve replacement (TAVR) with surgical aortic valve replacement (SAVR) have included mainly elderly patients >80 years. The authors investigated comparative in-hospital outcomes of younger patients <75 years undergoing transfemoral (TF) TAVR or isolated SAVR. METHODS AND RESULTS: A total of 6,972 patients aged 65-74 years undergoing TF-TAVR or SAVR between 2013 and 2014 were identified from the observational German Quality Assurance Registry on Aortic Valve Replacement (AQUA), which comprises all TAVR and SAVR procedures performed in Germany...
February 27, 2018: EuroIntervention
P Zaoui, T Hannedouche, C Combe
Type 2 diabetes has an increasing prevalence. Life expectancy is dominated by cardiovascular risk, which is the leading cause of death in these patients. Up to one third of diabetic patients will develop diabetic nephropathy related to micro-angiopathy. Renal impairment further increases cardiovascular risk. Reducing cardiovascular morbidity and mortality is a major public health issue, as well as early preventing and managing chronic kidney disease (CKD). Good glycemic control prevents the micro-vascular complications of the disease (retinopathy, nephropathy, etc...
June 2017: Néphrologie & Thérapeutique
Hatem Ali, Tarek Abdelaziz, Fatima Abdelaal, Jyoti Baharani
The relationship between frailty and chronic kidney disease in elderly population has been recognized; however, studies concentrating on frailty in predialysis patients are limited. For nephrologists, the recognition of frailty is important as it has impact on decisions on the choice of dialysis modality and sometimes on whether dialysis is indeed in the patients' best interests. Many of the tools for routine assessment of frailty are not easily applicable to those clinicians not practicing elderly care medicine...
January 2018: Saudi Journal of Kidney Diseases and Transplantation
Varun Puvanesarajah, Raj Amin, Rabia Qureshi, Babar Shafiq, Ben Stein, Hamid Hassanzadeh, Seth Yarboro
INTRODUCTION: Proximal femur fractures are one of the most common fractures observed in dialysis-dependent patients. Given the large comorbidity burden present in this patient population, more information is needed regarding post-operative outcomes. The goal of this study was to assess morbidity and mortality following operative fixation of femoral neck fractures in the dialysis-dependent elderly. METHODS: The full set of medicare data from 2005 to 2014 was retrospectively analyzed...
February 10, 2018: Archives of Orthopaedic and Trauma Surgery
Rui Abreu, Sara Rioja, Joaquin Vallespin, Xavier Vinuesa, Ruben Iglesias, Jose Ibeas
BACKGROUND: Native arteriovenous fistula (AVF) is considered the gold standard of vascular access for hemodialysis due to its longer survival, fewer complications, lower mortality and costs. Patency is important for effective dialysis treatment and this remains a challenge in nephrology. There are no well-defined prognostic factors for early and long-term AVF survival. The aim of this study was to evaluate comorbidity, analytical and ultrasound (US) variables as prognostic factors for early failure and AVF patency...
February 8, 2018: International Angiology: a Journal of the International Union of Angiology
Anish Gupta, Deven Juneja, Omender Singh, Suneel Kumar Garg, Varun Arora, Desh Deepak
Objective: Chikungunya is generally a mild disease, rarely requiring Intensive Care Unit (ICU) admission. However, certain populations may develop organ dysfunction necessitating ICU admission. The purpose of the study was to assess the clinical profile and course of chikungunya patients admitted to the ICU, and to ascertain factors linked with poor outcome. Methods: All patients with chikungunya admitted to ICU were included in the study. Admission Acute Physiology and Chronic Health Evaluation (APACHE) II score and sequential organ failure assessment (SOFA) score were calculated...
January 2018: Indian Journal of Critical Care Medicine
Adriana Martini, Adriano Ammirati, Carlos Garcia, Carolina Andrade, Odete Portela, Maysa S Cendoroglo, Ricardo Sesso
PURPOSE: The diagnosis of chronic kidney disease (CKD) in elderly individuals has been increasing. The objective of this study was to evaluate physical, mental and social aspects in longevous elderly patients with CKD. METHODS: Eighty patients with CKD (stage 4 and 5, not on dialysis) and 60 longevous elderly (≥ 80 years) paired by gender and age living in the community were evaluated. Physical, cognitive, social and quality of life aspects were analyzed according to the following scales: Charlson comorbidity index, Medical Outcomes Study Short Form 36-Item (SF-36), Medical Outcomes Study, Boston Naming Test, verbal fluency test (animal naming), sit-to-stand test, gait speed, and the Mini-Mental state examination...
February 5, 2018: International Urology and Nephrology
Keiichi Sumida, Shungo Yamamoto, Tadao Akizawa, Shunichi Fukuhara, Shingo Fukuma
BACKGROUND: Short-term weight gains and losses are associated with a lower and higher mortality risk, respectively, in patients undergoing hemodialysis (HD). However, little is known about their association with the risk of subsequent hospitalization. METHODS: In a prospective cohort of 1,804 HD patients aged ≥65 years enrolled in the Japanese Dialysis Outcomes and Practice Patterns Study phases 3 (2005-2008) and 4 (2009-2011), we examined the associations between changes in body mass index (BMI) over a 4-month baseline period (<-3%, -3 to <-1%, -1 to <1% [reference], 1 to <3%, and ≥3%) and subsequent risk of all-cause, cardiovascular, and noncardiovascular hospitalization using Cox models with adjustment for potential confounders...
January 24, 2018: American Journal of Nephrology
Hung-Chieh Wu, Lin-Chien Lee, Wei-Jie Wang
OBJECTIVES: This study examines the associations between total testosterone levels and dialysis mortality. METHODS: Elderly men who initiate hemodialysis in Taoyuan General Hospital from January 2012 to June 2017 were enrolled. We reviewed clinical characteristics and biochemical data from start of dialysis and followed over a 5-year period after dialysis. Body composition parameters were assessed 3-6 months after dialysis. Skeletal muscle mass index (SMMI) was defined by skeletal muscle mass divided by squared height...
January 25, 2018: Journal of Clinical Laboratory Analysis
Sophie De Seigneux, Belen Ponte, Karine Hadaya, Yassine Bouatou, Patrick Saudan
New antidiabetic drugs which slow effectively the course of diabetic nephropathy are now available. There is no benefit of prophylactic hydratation to prevent contrast nephropathy in patients with moderate chronic kidney disease. In elderly hemodialysis patients, hemodiafiltration seems better tolerated than conventional hemodialysis, although there is a similar dialysis-induced myocardial stress with both methods. Role of de novo donor-specific antibodies is better characterized, which may subsequently lead to new treatments of graft rejection...
January 10, 2018: Revue Médicale Suisse
Kristie J Lipford, Laura McPherson, Reem Hamoda, Teri Browne, Jennifer C Gander, Stephen O Pastan, Rachel E Patzer
BACKGROUND: Racial/ethnic, gender, and age disparities in access to renal transplantation among end-stage renal disease (ESRD) patients have been well documented, but few studies have explored health care staff attitudes towards these inequalities. Staff perceptions can influence patient care and outcomes, and identifying staff perceptions on disparities could aid in the development of potential interventions to address these health inequities. The objective of this study was to investigate dialysis staff (n = 509), primarily social workers and nurse managers, perceptions of renal transplant disparities in the Southeastern United States...
January 10, 2018: BMC Nephrology
Yoojin Noh, Jimin Lee, Sooyoung Shin, Inwhee Park, Soo Kyung Bae, Euichul Oh, Sukhyang Lee
Background Decline in estimated glomerular filtration rate (eGFR) is an important surrogate marker for the assessment of renal function. Addition of a second agent to angiotensin-converting-enzyme inhibitor (ACEI) or angiotensin II receptor blocker (ARB) treatment may improve current therapeutic strategies aimed at suppressing renal disease progression. Objective To determine the effect of cilostazol in combination with ACEI or ARB treatment on the decline in eGFR. Setting A tertiary hospital in Korea. Method In an observational cohort study, we analyzed 5505 patients who were prescribed ACEI or ARB and cilostazol or other antiplatelet agents...
December 27, 2017: International Journal of Clinical Pharmacy
Debajyoti Roy, Anupama Roy Chowdhury, Shrikant Pande, Jia Wen Kam
BACKGROUND: Increasing numbers of elderly patients are undergoing long-term dialysis. However, the role of dialysis in survival and quality of life is unclear, and poor outcomes may be associated with comorbidities rather than with age only. The initiation of unplanned dialysis in elderly patients with chronic kidney disease (CKD) has been reported to be associated with poor survival. We evaluated patient and practice factors associated with poor survival. METHODS: We performed a retrospective analysis of 90 consecutive elderly patients (≥75 years) with CKD initiated on long-term dialysis at our renal unit between October 2010 and February 2014...
December 19, 2017: BMC Nephrology
Julien O Riordan, Andrew Smyth, Pauline M Kane, Helen Noble, Sharon Beatty, Eileen Mannion, Camilla Murtagh, Ita Harnett
No abstract text is available yet for this article.
December 14, 2017: Journal of Pain and Symptom Management
Victor Manolov, Julia Petrova, Boris Bogov, Savina Hadjidekova, Vasil Vasilev, Dyana Yonova, Maria Petrova, Todor Kunchev, Yavor Jelev, Petar Jeliazkov, Borislav Marinov, Ivo Bogov, Zlatina Gramatikova, Silviya Voleva, Kamen Tzatchev, Latchezar Traykov
BACKGROUND: Chronic kidney disease (CKD) is a condition that involves 10% - 15% of population worldwide, which increases the risk of cardio-vascular diseases (CVD). Chronic kidney disease is one of the main reasons for illness and mortality in the world. Chronic kidney disease is a serious health problem caused by involvement of a large number of patients with kidney injury, especially in industrial countries. Among the main reasons for this are population living longer and the number of diseases in elderly persons, such as diabetes mellitus type 2, hypertension, and cardio-vascular diseases...
November 1, 2017: Clinical Laboratory
Keiko Konomura, Hideaki Nagai, Manabu Akazawa
Background: This study aimed to estimate the economic burden of community-acquired pneumonia (CAP) among elderly patients in Japan. In addition, the study evaluated the relationship between total treatment cost and CAP risk factors. Methods: An administrative database was searched for elderly patients (≥ 65 years old) who had pneumonia (ICD-10 code: J12-J18) and an antibiotic prescription between 1 June 2014 and 31 May 2015. The all-cause total healthcare costs of outpatient and inpatient CAP episodes were calculated...
2017: Pneumonia
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