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Elderly dialysis

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https://www.readbyqxmd.com/read/28329829/-end-of-life-care-i-m-not-going-to-worry-about-that-yet-health-literacy-gaps-and-end-of-life-planning-among-elderly-dialysis-patients
#1
Keren Ladin, Katie Buttafarro, Emily Hahn, Susan Koch-Weser, Daniel E Weiner
Purpose: Between 2000 and 2012, the incident dialysis population in the United States increased by nearly 60%, most sharply among adults 75 years and older. End-of-life (EOL) conversations among dialysis patients are associated with better patient-centered outcomes and lower use of aggressive interventions in the last month of life. This study examined how health literacy may affect engagement, comprehension, and satisfaction with EOL conversations among elderly dialysis patients. Design and Methods: Qualitative/descriptive study with semi-structured interviews about health literacy, EOL conversations, and goals of care with 31 elderly dialysis patients at 2 centers in Boston...
March 10, 2017: Gerontologist
https://www.readbyqxmd.com/read/28329396/heart-transplantation-in-selected-patients-aged-60-years-and-older-a-two-decade-retrospective-and-multicentre-analysis
#2
Christian Bosseau, Bernard Lelong, Sabine Pattier, Jean-Noël Trochu, Jean-Christian Roussel, Agnès Sirinelli, Michel Aupart, Céline Chabanne, Richard Dorent, Christelle Cantrelle, Philippe Mabo, Christophe Leclercq, Jean-Philippe Verhoye, Erwan Flécher
OBJECTIVES: This study analysed survival and long-term outcomes of heart transplantation in patients aged 60 years and older. We also analysed the impact of a national graft allocation priority [Super Emergency (SE)] and compared survival with younger patients in our centres and in France. METHODS: We performed a multicentre (University Hospitals in Nantes, Rennes and Tours), 2-decade retrospective study between 1 January 1994 and 31 December 2013. Elderly recipients were placed on the same list as younger patients; the use of marginal donors remained occasional...
March 7, 2017: European Journal of Cardio-thoracic Surgery
https://www.readbyqxmd.com/read/28319943/femoral-neck-x-ray-absorptiometry-parameters-and-peripheral-quantitative-computer-tomography-tibial-cortical-density-predict-survival-in-dialysis-patients
#3
Natalie Yap, Phillip Wong, Stella McGinn, Maria-Liza Nery, Jean Doyle, Lynda Wells, Phillip Clifton-Bligh, Roderick J Clifton-Bligh
BACKGROUND: Low bone mineral density (BMD) is a known independent predictor of mortality in the general elderly population. However, studies in patients with end-stage renal disease (ESRD) are limited. The present study evaluated mortality during long-term follow-up in a population of patients having dialysis for ESRD, in whom BMD was also measured. METHODS: Fifty-eight patients with ESRD were recruited consecutively from a dialysis clinic and followed prospectively for 6 years...
March 21, 2017: Nephron
https://www.readbyqxmd.com/read/28296252/research-on-handwashing-techniques-of-peritoneal-dialysis-patients-from-yiwu-southeast-china
#4
Yuanjun Ye, Xiaohui Zhang, Yansu Liu, Hongqing Lou, Zhangfei Shou
The aim of the present study was to evaluate handwashing technique, bacteriology, and factors influencing handwashing technique of 86 stable chronic peritoneal dialysis (PD) patients from Yiwu City in Southeast China. Based on the "Hygienic standard for disinfection in the hospital", we also performed sampling for bacteriology from PD operators after they washed their hands. We compared their clinical features including the pathogenic bacteria of their previous peritonitis episodes and their handwashing evaluation results according to their bacteriologic sampling results...
March 10, 2017: Therapeutic Apheresis and Dialysis
https://www.readbyqxmd.com/read/28279404/strategies-for-hemodialysis-access-a-vascular-surgeon-s-perspective
#5
Larry A Scher, Saadat Shariff
Problems related to hemodialysis access are a significant cause of morbidity and mortality in patients with end-stage renal disease. Physicians of all specialties who are involved in the placement and maintenance of vascular access for hemodialysis must have a long-term strategy for sequential placement of autogenous fistulas, transpositions, and prosthetic grafts to preserve access sites and to avoid long-term use of tunneled dialysis catheters. The Fistula First and KDOQI initiatives have provided strategies and algorithms for access placement in patients with chronic kidney disease...
March 2017: Techniques in Vascular and Interventional Radiology
https://www.readbyqxmd.com/read/28265980/outcomes-in-elderly-patients-admitted-to-the-intensive-care-unit-with-solid-tumors
#6
Edouard Auclin, Anaïs Charles-Nelson, Baptiste Abbar, Emmanuel Guérot, Stéphane Oudard, Caroline Hauw-Berlemont, Constance Thibault, Alexandra Monnier, Jean-Luc Diehl, Sandrine Katsahian, Jean-Yves Fagon, Julien Taieb, Nadia Aissaoui
BACKGROUND: As the population ages and cancer therapies improve, there is an increased call for elderly cancer patients to be admitted to the intensive care unit (ICU). This study aimed to assess short-term survival and prognostic factors in critically ill patients with solid tumors aged ≥65 years. METHODS: We conducted a retrospective study. The primary endpoint was ICU mortality. Resumption of anticancer therapy in patients who survived the ICU stay and 90-day mortality were secondary endpoints...
December 2017: Annals of Intensive Care
https://www.readbyqxmd.com/read/28240525/infrapopliteal-calcification-patterns-in-critical-limb-ischemia-diagnostic-pathologic-and-therapeutic-implications-in-the-search-for-the-endovascular-holy-grail
#7
Jihad A Mustapha, Larry J Diaz-Sandoval, Fadi Saab
Critical limb ischemia (CLI) represents the terminal stage of peripheral arterial disease (PAD) and is characterized by multilevel and multivessel disease. Amongst patients with infrainguinal disease, approximately one third have predominantly isolated infrapopliteal disease and the remaining two thirds, a combination of femoropopliteal and infrapopliteal disease. Isolated infrapopliteal disease is mainly seen in the elderly, diabetic, or dialysis-dependent patients. These patients have higher risk of amputation and shorter amputation-free survival...
February 27, 2017: Journal of Cardiovascular Surgery
https://www.readbyqxmd.com/read/28222929/magnesium-an-overlooked-electrolyte
#8
Jaya Kala, Ala Abudayyeh
BACKGROUND: Hypermagnesemia is rare and usually iatrogenic. Due to decreased renal function, older patients are generally more susceptible to hypermagnesemia than are younger patients. Because it is not one of the commonly assessed electrolytes in the blood work panel of patients, high levels are usually missed. CASE REPORT: An elderly gentleman with history of leukemia presented with complaints of shortness of breath and extreme weakness while walking. He was diagnosed with severe hypermagnesemia, but unfortunately succumbed to cardiorespiratory arrest...
February 17, 2017: Journal of Emergency Medicine
https://www.readbyqxmd.com/read/28212179/hard-choices-better-outcomes-a-review-of-shared-decision-making-and-patient-decision-aids-around-dialysis-initiation-and-conservative-kidney-management
#9
Janet L Davis, Sara N Davison
PURPOSE OF REVIEW: Patients reaching end-stage kidney disease face difficult decisions, including choosing among renal replacement therapies (RRTs). With an increasingly elderly and frail population, there is growing interest in conservative kidney management (CKM) as a viable alternative to dialysis. Shared decision-making (SDM) is a patient-centered approach to these decisions, in which choices are viewed within the explicitly discussed values and preferences of the patient. Patient decision aids (PDAs) are tools designed to facilitate these discussions...
February 16, 2017: Current Opinion in Nephrology and Hypertension
https://www.readbyqxmd.com/read/28210031/effects-of-exercise-therapy-during-dialysis-for-elderly-patients-undergoing-maintenance-dialysis
#10
Yusuke Chigira, Takahiro Oda, Masataka Izumi, Tukasa Yoshimura
[Purpose] Exercise therapy during dialysis is currently being recommended since it is easy for patients to follow and results in high participation rates. In this study, this therapy was performed for elderly patients undergoing maintenance dialysis, and its effects were examined. [Subjects and Methods] Seven elderly patients (age: 70.6 ± 4.4) with chronic renal failure, who were able to perform exercises during maintenance dialysis, received the exercise therapy 2 or 3 times weekly for 3 months. Lower-limb muscle strength as well as the standardized dialysis dose (Kt/V) was measured before and after intervention...
January 2017: Journal of Physical Therapy Science
https://www.readbyqxmd.com/read/28176909/outcomes-of-renal-function-in-elderly-patients-with-acute-kidney-injury
#11
Qinglin Li, Meng Zhao, Jing Du, Xiaodan Wang
OBJECTIVES: The aim of this study was to explore the prognostic impact of clinical factors on the short-term outcomes of renal function (RF) in very elderly patients with acute kidney injury (AKI). PATIENTS AND METHODS: We carried out a retrospective cohort study of only very elderly patients who developed AKI at the geriatric department of a tertiary medical center during the period 2007-2015. All patients with AKI were followed up for 90 days after AKI diagnosis or until death...
2017: Clinical Interventions in Aging
https://www.readbyqxmd.com/read/28176820/dipstick-proteinuria-level-is-significantly-associated-with-pre-morbid-and-in-hospital-functional-status-among-hospitalized-older-adults-a-preliminary-study
#12
Chia-Ter Chao, Hung-Bin Tsai, Chih-Kang Chiang, Jenq-Wen Huang, Kuan-Yu Hung
Although chronic kidney disease (CKD) is associated with functional decline, whether proteinuria alone is associated with functional statuses over the course of acute illnesses independent of CKD is unclear. During 2014, we prospectively enrolled non-dialysis patients aged ≥65 years, and all participants underwent spot dipstick urinalysis on admission, divided into 3 groups according to the results (none, trace to 1 + , and 2 + or higher); functional status was evaluated using the pre-morbid and in-hospital Barthel index (BI) scores...
February 8, 2017: Scientific Reports
https://www.readbyqxmd.com/read/28161264/ten-years-trends-in-renal-replacement-therapy-for-end-stage-renal-disease-in-mainland-france-lessons-from-the-french-renal-epidemiology-and-information-network-rein-registry
#13
Cécile Vigneau, Anne Kolko, Bénédicte Stengel, Christian Jacquelinet, Paul Landais, Philippe Rieu, Sahar Bayat, Cécile Couchoud
BACKGROUND: The incidence rate of renal replacement therapy (RRT) for end-stage renal disease (ESRD) is decreasing in several countries, but not in France. We studied the RRT trends in mainland France from 2005 to 2014 to understand the reasons for this discrepancy and determine the effects of ESRD management changes. METHODS: Data were extracted from the French Renal Epidemiology and Information Network registry. Time trends of RRT incidence and prevalence rates, patients' clinical and treatment characteristics were analysed using the Joinpoint regression program and annual percentage changes...
February 1, 2017: Néphrologie & Thérapeutique
https://www.readbyqxmd.com/read/28153936/the-3-year-incidence-of-gout-in-elderly-patients-with-ckd
#14
Vivian S Tan, Amit X Garg, Eric McArthur, Ngan N Lam, Manish M Sood, Kyla L Naylor
BACKGROUND AND OBJECTIVES: The risk of gout across CKD stages is not well described. DESIGN, SETTING, PARTICIPANTS, & MEASUREMENTS: We performed a retrospective cohort study using linked health care databases from Ontario, Canada from 2002 to 2010. The primary outcome was the 3-year cumulative incidence of gout, on the basis of diagnostic codes. We presented our results by level of kidney function (eGFR≥90 ml/min per 1.73 m(2), 60-89, 45-59, 30-44, 15-29, and chronic dialysis) and by sex...
February 2, 2017: Clinical Journal of the American Society of Nephrology: CJASN
https://www.readbyqxmd.com/read/28153192/current-challenges-and-opportunities-in-pd
#15
REVIEW
Philip Kam-Tao Li, Vickie Wai-Ki Kwong
Despite the gradual increased use of peritoneal dialysis (PD) globally around the world, it is recognized that a number of areas in PD as a renal-replacement therapy require attention and improvements. The current challenges in PD include how to tackle technique failure and sustain long-term PD, manage and prevent peritoneal infections, malnutrition and inflammation, cardiovascular mortality, volume overload, glucose exposure, adequacy of solute removal, peritoneal access, peritoneal physiology and changes with long-term PD, patient fatigue, psychosocial issues, and care of elderly patients on PD...
January 2017: Seminars in Nephrology
https://www.readbyqxmd.com/read/28122500/costs-of-care-at-the-end-of-life-among-elderly-patients-with-chronic-kidney-disease-patterns-and-predictors-in-a-nationwide-cohort-study
#16
Bradley Chen, Victoria Y Fan, Yiing-Jenq Chou, Chin-Chi Kuo
BACKGROUND: Despite the urgent need for evidence to guide the end-of-life (EOL) care for patients with chronic kidney disease (CKD), we have limited knowledge of the costs and intensity of EOL care in this population. The present study examined patterns and predictors for EOL care intensity among elderly patients with CKD. METHODS: We conducted a retrospective nationwide cohort study utilizing the Taiwan National Health Insurance (NHI) Research Database. A total of 65,124 CKD patients aged ≥ 60 years, who died in hospitals or shortly after discharge between 2002 and 2012 were analyzed...
January 26, 2017: BMC Nephrology
https://www.readbyqxmd.com/read/28097174/uncertainty-the-overbearing-lived-experience-of-the-elderly-people-undergoing-hemodialysis-a-qualitative-study
#17
Robab Sahaf, Ehteram Sadat Ilali, Hamid Peyrovi, Ahmad Ali Akbari Kamrani, Fatemeh Spahbodi
BACKGROUND: The chronic kidney disease is a major health concern. The number of the elderly people with chronic renal failure has increased across the world. Dialysis is an appropriate therapy for the elderly, but it involves certain challenges. The present paper reports uncertainty as part of the elderly experiences of living with hemodialysis. METHODS: This qualitative study applied Max van Manen interpretative phenomenological analysis to explain and explore experiences of the elderly with hemodialysis...
January 2017: International Journal of Community Based Nursing and Midwifery
https://www.readbyqxmd.com/read/28089414/acupressure-effect-on-sleep-quality-a-systematic-review-and-meta-analysis
#18
REVIEW
Alexander Waits, You-Ren Tang, Hao-Min Cheng, Chen-Jei Tai, Li-Yin Chien
Acupressure is a non-invasive treatment in which pressure is applied to specific body points. Following public health concerns about poor sleep quality and increasing interest in alternative treatments, a systematic review and a meta-analysis were designed to evaluate the effects of acupressure on the quality of sleep. Ten English (PubMed, CENTRAL, CINAHL etc.) and five Chinese (CNKI, WANFANG etc.) databases were searched and the validity of the eligible studies was critically appraised. Thirty-two eligible randomized controlled trials of moderate to high quality which employed polysomnography, actigraphy, or self-assessment sleep quality tools were included...
December 22, 2016: Sleep Medicine Reviews
https://www.readbyqxmd.com/read/28088773/epidemiology-and-outcome-of-acute-pancreatitis-in-end-stage-renal-disease-dialysis-patients-a-10-year-national-cohort-study
#19
Hung-Jui Chen, Jhi-Joung Wang, Wen-Ing Tsay, Shwu-Huey Her, Cheng-Heng Lin, Chih-Chiang Chien
BACKGROUND: The objective of this study is to determine the incidence and severity of acute pancreatitis (AP) in patients with end-stage renal disease (ESRD) on dialysis and whether the dialysis modality [hemodialysis (HD) versus peritoneal dialysis (PD)] confers a higher risk for AP as well as complications or mortality related to AP. METHODS: We analyzed national health insurance claims data of 67 078 ESRD patients initiating dialysis between 1999 and 2007 in Taiwan...
January 14, 2017: Nephrology, Dialysis, Transplantation
https://www.readbyqxmd.com/read/28077080/should-patients-older-than-65-years-be-offered-a-second-kidney-transplant
#20
Kristian Heldal, Anders Hartmann, Kjersti Lønning, Torbjørn Leivestad, Anna V Reisæter, Pål-Dag Line, Hallvard Holdaas, Karsten Midtvedt
BACKGROUND: Age and number of recipients in need of kidney re-transplantation are increasing. Re-transplantation practices and outcomes in elderly recipients are not previously explored. We aimed to retrospectively evaluate the outcomes of recipients 65 years and older receiving their second deceased donor allograft. METHODS: The study was designed as a retrospective registry based study. All recipients 65 years or older who received a deceased donor kidney transplant at Oslo University Hospital between 2000 and 2014 were included in the study...
January 11, 2017: BMC Nephrology
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