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https://www.readbyqxmd.com/read/27924802/clinical-course-of-acute-kidney-injury-in-elderly-individuals-above-80-years
#1
Isabell Funk, Eric Seibert, Silke Markau, Matthias Girndt
BACKGROUND/AIMS: Aging is associated with renal function decline and elderly patients are more vulnerable to acute kidney injury (AKI). The causes and prognosis of AKI according to new KDIGO definition that broadened the diagnosis and included more patients without dialysis dependence have not yet been compared between younger and elderly patients. METHODS: In a retrospective analysis all patients with AKI admitted to a tertiary care Nephrology department (N=424) were included...
December 8, 2016: Kidney & Blood Pressure Research
https://www.readbyqxmd.com/read/27886156/conformity-scores-differentiate-older-hemodialyzed-patients-and-patients-with-continuous-peritoneal-dialysis
#2
Zbigniew Nowak, Krzysztof Laudanski
BACKGROUND Conformity is a psychological variable related to the propensity of an individual to match his or her behavior and opinion to the perceived social and cultural norm, even if these do not represent the true beliefs of the person. The aim of the present study was to investigate whether the psychological variable of conformity is different in two distinct modes of renal replacement therapy (RRT) in end-stage renal disease (ESRD). MATERIAL AND METHODS A total of 56 hemodialyzed patients (HD group), 45 continuous ambulatory peritoneal dialysis patients (CAPD group) and 62 healthy volunteers (CONTR group) were enrolled in the study...
November 25, 2016: Medical Science Monitor: International Medical Journal of Experimental and Clinical Research
https://www.readbyqxmd.com/read/27883315/the-need-for-accurate-risk-prediction-models-for-road-mapping-shared-decision-making-and-care-planning-for-the-elderly-with-advanced-chronic-kidney-disease
#3
Marijke Stryckers, Evi V Nagler, Wim Van Biesen
As people age, chronic kidney disease becomes more common, but it rarely leads to end-stage kidney disease. When it does, the choice between dialysis and conservative care can be daunting, as much depends on life expectancy and personal expectations of medical care. Shared decision making implies adequately informing patients about their options, and facilitating deliberation of the available information, such that decisions are tailored to the individual's values and preferences. Accurate estimations of one's risk of progression to end-stage kidney disease and death with or without dialysis are essential for shared decision making to be effective...
November 1, 2016: Prilozi (Makedonska Akademija Na Naukite i Umetnostite. Oddelenie za Medicinski Nauki)
https://www.readbyqxmd.com/read/27861296/are-octogenarians-with-end-stage-renal-disease-candidates-for-renal-transplantation
#4
Kjersti Lønning, Karsten Midtvedt, Torbjørn Leivestad, Anna V Reisæter, Pål-Dag Line, Anders Hartmann, Kristian Heldal
BACKGROUND: Elderly patients are the fastest-growing group in need of renal transplantation. This study puts focus on renal transplant recipients in their 80th year or longer at time of engraftment. Is there evidence to support an absolute upper age limit for renal transplantation? METHODS: Recipients in their 80th year or longer, transplanted between 1983 and 2015, were included. Data were retrieved from the Norwegian Renal Registry in the end of October 2015. Graft and patient survivals were compared with recipients aged 70 to 79 years at transplantation...
December 2016: Transplantation
https://www.readbyqxmd.com/read/27843302/factors-influencing-access-to-education-decision-making-and-receipt-of-preferred-dialysis-modality-in-unplanned-dialysis-start-patients
#5
Anna Machowska, Mark Dominik Alscher, Satyanarayana Reddy Vanga, Michael Koch, Michael Aarup, Abdul Rashid Qureshi, Bengt Lindholm, Peter A Rutherford
OBJECTIVES: Unplanned dialysis start (UPS) leads to worse clinical outcomes than planned start, and only a minority of patients ever receive education on this topic and are able to make a modality choice, particularly for home dialysis. This study aimed to determine the predictive factors for patients receiving education, making a decision, and receiving their preferred modality choice in UPS patients following a UPS educational program (UPS-EP). METHODS: The Offering Patients Therapy Options in Unplanned Start (OPTiONS) study examined the impact of the implementation of a specific UPS-EP, including decision support tools and pathway improvement on dialysis modality choice...
2016: Patient Preference and Adherence
https://www.readbyqxmd.com/read/27828582/-factors-associated-with-the-frailty-of-elderly-people-with-chronic-kidney-disease-on-hemodialysis
#6
Gabriela Dutra Gesualdo, Marisa Silvana Zazzetta, Karina Gramani Say, Fabiana de Souza Orlandi
The scope of this article is to identify sociodemographic and clinical factors associated with the frailty of elderly people with chronic kidney disease on hemodialysis. This involved a correlational, cross-sectional study conducted in a dialysis center in the state of São Paulo. The sample consisted of 60 participants. The Participant Characterization Instrument was used for extracting sociodemographic and clinical data and the Edmonton Frail Scale was used to evaluate the level of frailty. Multivariate logistic regression was used to identify the factors associated with frailty...
November 2016: Ciência & Saúde Coletiva
https://www.readbyqxmd.com/read/27822026/age-influence-on-renalase-and-catecholamines-concentration-in-hypertensive-patients-including-maintained-dialysis
#7
Edyta Zbroch, Dominika Musialowska, Ewa Koc-Zorawska, Jolanta Malyszko
BACKGROUND: Hypertension in elderly patients is one of the main problems in cardiovascular diseases. The sympathetic nervous system hyperactivity seen in older patients is a known risk factor for hypertension and other cardiovascular events as well as chronic kidney disease. Renalase, secreted by the kidney and circulated in blood, may regulate the sympathetic tone by catecholamine degradation and in this way has an impact on cardiovascular and renal complications. OBJECTIVE: To assess the impact of age on renalase and catecholamine concentration in hypertensive patients, including those on dialyses and its possible relation to blood pressure control and cardiovascular disease...
2016: Clinical Interventions in Aging
https://www.readbyqxmd.com/read/27795626/anti-glomerular-basement-membrane-crescentic-glomerulonephritis-a-report-from-india-and-review-of-literature
#8
A Gupta, V Agrawal, A Kaul, R Verma, R Pandey
Anti-glomerular basement membrane (anti-GBM) disease is an autoimmune disease that most commonly presents as rapidly progressive glomerulonephritis with or without pulmonary involvement. It is characterized by the presence of antibodies directed to antigenic targets within glomerular and alveolar basement membranes. This study was performed to evaluate the clinicopathological features and outcome in anti-GBM crescentic glomerulonephritis (CrGN) at a tertiary care center in North India over a period of 9 years (January 2004 to December 2012)...
September 2016: Indian Journal of Nephrology
https://www.readbyqxmd.com/read/27773426/peritoneal-or-hemodialysis-for-the-frail-elderly-patient-the-choice-of-2-evils
#9
Edwina A Brown, Frederic O Finkelstein, Osasuyi U Iyasere, Alan S Kliger
Management of older people on dialysis requires focus on the wider aspects of aging as well as dialysis. Almost all frail and older patients receiving dialysis will default to in-center hemodialysis, although the availability of assisted peritoneal dialysis enables dialysis at home. As with any disease management decision, patients approaching end-stage renal disease need all the appropriate facts about their prognosis, the natural history of their disease without dialysis, and the resulting outcomes and complications of the different dialysis modalities...
October 20, 2016: Kidney International
https://www.readbyqxmd.com/read/27772639/intensive-hemodialysis-blood-pressure-and-antihypertensive-medication-use
#10
George L Bakris, John M Burkart, Eric D Weinhandl, Peter A McCullough, Michael A Kraus
Hypertension is a cardinal feature of end-stage renal disease (ESRD). Hypertensive nephropathy is the primary cause of ESRD for nearly 30% of patients, and the prevalence of hypertension is >85% in new patients with ESRD. In contemporary hemodialysis (HD) patients, mean predialysis systolic blood pressure (SBP) is nearly 150mmHg, and about 70%, 50%, and 40% use β-blockers, calcium channel blockers, and renin-angiotensin system inhibitors, respectively. Predialysis SBP generally exhibits a U-shaped association with mortality risk...
November 2016: American Journal of Kidney Diseases: the Official Journal of the National Kidney Foundation
https://www.readbyqxmd.com/read/27740520/%C3%A2-simultaneous-liver-and-kidney-transplantation-in-elderly-patients-outcomes-and-validation-of-a-clinical-risk-score-for-patient-selection
#11
Kristopher P Croome, David D Lee, Justin M Burns, Dana K Perry, Justin H Nguyen, Andrew P Keaveny, Hani M Wadei, C Burcin Taner
:  Introduction and aim. Many transplant programs have expanded eligibility to include patients previously ineligible because of advanced age. Outcomes of simultaneous liver-kidney transplantation (SLK) in recipients with advanced age are not known. MATERIAL AND METHODS: Data from patients undergoing transplantation between 2002 and 2015 were obtained from the UNOS Standard Analysis and Research file. RESULTS: SLK recipients aged ≥ 65 years (N = 677), SLK recipients aged < 65 years (N = 4517), and recipients of liver transplant alone(LTA) aged ≥ 65 years(N = 8495) were compared...
November 2016: Annals of Hepatology
https://www.readbyqxmd.com/read/27737913/clostridium-difficile-infection-in-dialysis-patients
#12
Ankita Tirath, Sandra Tadros, Samuel L Coffin, Kristina W Kintziger, Jennifer L Waller, Stephanie L Baer, Rhonda E Colombo, Lu Y Huber, Mufaddal F Kheda, N Stanley Nahman
Clostridium difficile infection (CDI) is the most common cause of nosocomial diarrhea. Patients with end-stage renal disease (ESRD) may be at increased risk for CDI. Patients with ESRD with CDI have increased mortality, longer length of stay, and higher costs. The present studies extend these observations and address associated comorbidities, incidence of recurrence, and risk factors for mortality. We queried the United States Renal Data System (USRDS) for patients with ESRD diagnosed with CDI, and assessed for the incidence of infection, comorbidities, and mortality...
October 13, 2016: Journal of Investigative Medicine: the Official Publication of the American Federation for Clinical Research
https://www.readbyqxmd.com/read/27729570/stretching-the-limits-of-renal-transplantation-in-elderly-recipients-of-grafts-from-elderly-deceased-donors
#13
Hessel Peters-Sengers, Stefan P Berger, Martin B A Heemskerk, Doaa Al Arashi, Jaap J Homan van der Heide, Aline C Hemke, Ineke J M Ten Berge, Mirza M Idu, Michiel G H Betjes, Arjan D van Zuilen, Luuk B Hilbrands, Aiko P J de Vries, Azam S Nurmohamed, Maarten H Christiaans, L W Ernest van Heurn, Johan W de Fijter, Frederike J Bemelman
An increasing number of elderly patients (≥65 years) receive a donor kidney from elderly donors after brain death (DBD) or after circulatory death (DCD). These organs are allocated within the Eurotransplant Senior Program, but outcomes must be evaluated. From the Dutch Organ Transplantation Registry, we selected 3597 recipients (≥18 years) who received a first DBD or DCD kidney during 2002-2012, and categorized them as young or elderly recipients receiving a graft from either a young or elderly donor, stratified by donor type...
October 11, 2016: Journal of the American Society of Nephrology: JASN
https://www.readbyqxmd.com/read/27684071/arterio-venous-fistula-is-it-critical-for-prolonged-survival-in-the-over-80-s-starting-haemodialysis
#14
Adam D Jakes, Poonam Jani, Victoria Allgar, Archie Lamplugh, Ahmed Zeidan, Sunil Bhandari
BACKGROUND: Dialysis in elderly patients (>80-years-old) carries a poor prognosis, but little is known about the most effective vascular access method in this age group. An arteriovenous fistula (AVF) is both time-consuming and initially expensive, requiring surgical insertion. A central venous catheter (CVC) is initially a cheaper alternative, but carries a higher risk of infection. We examined whether vascular access affected 1-year and 2-year mortality in elderly patients commencing haemodialysis...
2016: PloS One
https://www.readbyqxmd.com/read/27682843/epidemiology-and-outcomes-of-acute-kidney-injury-in-elderly-chinese-patients-a-subgroup-analysis-from-the-each-study
#15
Shuwang Ge, Sheng Nie, Zhangsuo Liu, Chunbo Chen, Yan Zha, Jing Qian, Bicheng Liu, Siyuan Teng, Anping Xu, Wei Bin, Xin Xu, Gang Xu
BACKGROUND: Information on acute kidney injury (AKI) in elderly hospitalized patients is limited. This study aims to assess the incidence, risk factors and outcomes of AKI in elderly Chinese patients. METHOD: The Epidemiology of AKI in Chinese Hospitalized adults (EACH) study is a multicenter, retrospective cohort study conducted in nine regional central hospitals across China. Patients aged more than 65 years were selected from the EACH study for this analysis...
September 29, 2016: BMC Nephrology
https://www.readbyqxmd.com/read/27680765/introduction-of-renal-key-performance-indicators-associated-with-increased-uptake-of-peritoneal-dialysis-in-a-publicly-funded-health-service
#16
Nigel D Toussaint, Lawrence P McMahon, Gregory Dowling, Stephen G Holt, Gillian Smith, Maria Safe, Richard Knight, Kathleen Fair, Leanne Linehan, Rowan G Walker, David A Power
♦ Background: Increased demand for treatment of end-stage kidney disease has largely been accommodated by a costly increase in satellite hemodialysis (SHD) in most jurisdictions. In the Australian State of Victoria, a marked regional variation in the uptake of home-based dialysis suggests that use of home therapies could be increased as an alternative to SHD. An earlier strategy based solely on increased remuneration had failed to increase uptake of home therapies. Therefore, the public dialysis funder adopted the incidence and prevalence of home-based dialysis therapies as a key performance indicator (KPI) for its health services to encourage greater uptake of home therapies...
September 28, 2016: Peritoneal Dialysis International: Journal of the International Society for Peritoneal Dialysis
https://www.readbyqxmd.com/read/27676190/risk-factors-and-prognosis-of-cardiorenal-syndrome-type-1-in-elderly-chinese-patients-a-retrospective-observational-cohort-study
#17
Wenxue Hu, Wenna He, Wei Liu, Xiaowu Fang, Yanhua Wu, Feng Yu, Wenke Hao
BACKGROUND/AIMS: Cardiorenal syndrome type 1 (CRS1) is a syndrome characterized by a rapid worsening of cardiac function leading to acute kidney injury (AKI). The aims of this study were to investigate the risk factors and the prognosis of CRS1 in elderly patients. METHODS: A total of 312 elderly patients (≥60 years old) with acute heart failure (AHF) were studied. They were assigned as CRS1 (suffered from in-hospital AKI) or NCRS1 (without AKI) group. Clinical and laboratory data were recorded...
2016: Kidney & Blood Pressure Research
https://www.readbyqxmd.com/read/27673681/acute-kidney-injury-treated-with-dialysis-outside-the-intensive-care-unit-a-retrospective-observational-single-center-study
#18
Hannelore Sprenger-Mähr, Emanuel Zitt, Karl Lhotta
INTRODUCTION: The number of patients suffering from acute kidney injury requiring dialysis (AKI-D) is increasing. Whereas causes and outcome of AKI-D in the intensive care unit (ICU) are described extensively, few data exist about AKI-D patients treated outside the ICU. Aim of this study was to identify the causes of AKI-D, determine in-depth the comorbid conditions and outcome of this particular patient group and identify possibilities for its prevention. METHODS: We retrospectively studied all AKI-D patients treated outside the ICU in a single nephrology referral center between January 2010 and June 2015...
2016: PloS One
https://www.readbyqxmd.com/read/27671768/risk-factors-for-30-day-postoperative-complications-following-open-reduction-internal-fixation-of-proximal%C3%A2-ulna-fractures
#19
Nikunj N Trivedi, Matthew R Cohn, Samir K Trehan, Aaron Daluiski
PURPOSE: Fractures of the proximal ulna are common injuries in the elderly population. These fractures can be managed nonsurgically or with open reduction internal fixation (ORIF). Whereas nonsurgical management may lead to a relative loss of elbow extension and to nonunion, ORIF carries a risk of complications. Although complications specific to the orthopedic intervention have been reported, few studies have identified postoperative systemic complications in this higher-risk group. The purposes of this study were to determine the rate of systemic complications in patients undergoing surgical fixation of proximal ulna fractures and to determine risk factors for complications...
September 23, 2016: Journal of Hand Surgery
https://www.readbyqxmd.com/read/27669324/symptom-management-in-patients-with-stage-5-ckd-opting-for-conservative-management
#20
REVIEW
Sheila Johnston
Chronic kidney disease (CKD) stages 3-5 now affects 8.5% of adults in the United Kingdom; with 4% of patients expected to reach stage 5 CKD. Increasing numbers of older patients are contributing to the growth of demand of kidney services. With the exception of transplantation, dialysis has been the main form of renal replacement therapy (RRT) for advanced CKD. This elderly population is usually too frail and has many other co-existing medical complaints or co morbidities to undergo transplantation. Dialysis is an invasive treatment, and some frail elderly patients can experience many dialysis related symptoms...
September 22, 2016: Healthcare (Basel, Switzerland)
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