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Elderly dialysis

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https://www.readbyqxmd.com/read/28640530/how-does-age-affect-the-outcome-of-kidney-transplantation-in-elderly-recipients
#1
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
#2
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
#3
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
#4
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
#5
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
#6
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
#7
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
#8
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
https://www.readbyqxmd.com/read/28558719/treatment-adherence-and-perception-in-patients-on-maintenance-hemodialysis-a-cross-sectional-study-from-palestine
#9
Karam Sh Naalweh, Mohammad A Barakat, Moutaz W Sweileh, Samah W Al-Jabi, Waleed M Sweileh, Sa'ed H Zyoud
BACKGROUND: Adherence to diet recommendations, fluid restriction, prescribed medications, and attendance at hemodialysis (HD) sessions are essential for optimal and effective treatment of patients with end-stage renal disease. No data regarding this issue are available from Palestine. Therefore, this study was carried out to assess adherence to diet, fluid restriction, medications, and HD sessions. METHODS: A cross-sectional study of HD patients at An-Najah National University Hospital was carried out during summer, 2016...
May 30, 2017: BMC Nephrology
https://www.readbyqxmd.com/read/28558717/timing-of-commencement-of-maintenance-dialysis-and-mortality-in-young-and-older-adults-in-singapore
#10
Liang Feng, Ai Zhen Jin, John Carson Allen, Khuan Yew Chow, Tazeen Hasan Jafar
BACKGROUND: The benefit of early dialysis initiation remains controversial with a paucity of data in Asians. Therefore, we undertook this study to investigate the association between timing of initiation of dialysis and mortality in Singapore. METHODS: The study used data from the Singapore Renal Registry database on 3286 patients with incident end-stage renal disease (ESRD) who commenced maintenance dialysis between January 2008 and December 2011. The data was further linked with the National Death Registry to acquire survival information until December 2013...
May 30, 2017: BMC Nephrology
https://www.readbyqxmd.com/read/28555712/frailty-in-end-stage-renal-disease-patients-under-dialysis-and-its-association-with-clinical-and-biochemical-markers
#11
V Poveda, M Filgueiras, V Miranda, A Santos-Silva, C Paúl, E Costa
Frailty is a common complication in elderly patients with end-stage renal disease (ESRD) under dialysis, which is a strong risk factor for low quality of life, morbidity, and mortality. In this work, we aimed to evaluate the prevalence of frailty in a group of Portuguese ESRD patients, and its association with socio-demographic, clinical and biochemical markers. We performed a cross-sectional study with 83 ESRD patients (44 males and 39 females, 64.3 [±14.6] years old) on regular dialysis. The classification of the ESRD patients as robust, pre-frail and frail was performed using the FRAIL questionnaire...
2017: Journal of Frailty & Aging
https://www.readbyqxmd.com/read/28538218/dialysis-therapy-and-conservative-management-of-advanced-chronic-kidney-disease-in-the-elderly-a-systematic-review
#12
Supakanya Wongrakpanich, Paweena Susantitaphong, Suramath Isaranuwatchai, Jirat Chenbhanich, Somchai Eiam-Ong, Bertrand L Jaber
BACKGROUND: Dialysis in older adults with chronic kidney disease (CKD) and comorbidities may not be associated with improved life expectancy compared to conservative management. To inform clinical practice, we performed a systematic review of all available studies examining this hypothesis. METHODS: We performed a systematic review of retrospective and prospective cohort studies of older adults with stage-5 CKD who chose dialysis (hemodialysis or peritoneal dialysis) or opted for conservative management (including management of complications of CKD and palliative care)...
May 25, 2017: Nephron
https://www.readbyqxmd.com/read/28514785/effect-of-age-on-the-association-of-vascular-access-type-with-mortality-in-a-cohort-of-incident-end-stage-renal-disease-patients
#13
Tarek Saleh, Keiichi Sumida, Miklos Z Molnar, Praveen K Potukuchi, Fridtjof Thomas, Jun Ling Lu, Geeta G Gyamlani, Elani Streja, Kamyar Kalantar-Zadeh, Csaba P Kovesdy
BACKGROUND/AIMS: All hemodialysis (HD) patients are generally recommended to create a fistula first; but to create a mature arteriovenous fistula (AVF) can be challenging in elderly individuals. It is unclear if elderly incident HD patients derive a survival benefit from an AVF over an arteriovenous graft (AVG) or a tunneled central venous catheter (TDC). METHODS: We examined the association of vascular access type (AVF, AVG, and TDC with and without a maturing AVF/AVG at dialysis transition) at HD initiation with all-cause, cardiovascular (CV), and infection-related mortality in 46,786 US veterans using Cox models with adjustment for confounders...
May 18, 2017: Nephron
https://www.readbyqxmd.com/read/28514783/dialysis-access-as-an-area-of-improvement-in-elderly-incident-hemodialysis-patients-results-from-a-cohort-study-from-the-international-monitoring-dialysis-outcomes-initiative
#14
Jochen G Raimann, Claudia Barth, Len A Usvyat, Priscila Preciado, Bernard Canaud, Michael Etter, Xiaoqi Xu, Adrian Guinsburg, Christina Marelli, Neill Duncan, Albert Power, Frank M van der Sande, Jeroen P Kooman, Stephan Thijssen, Yuedong Wang, Peter Kotanko
BACKGROUND: Commencing hemodialysis (HD) using a catheter is associated with a higher risk of adverse outcomes, and early conversion from central-venous catheter (CVC) to arteriovenous fistula/graft (non-CVC) improves outcomes. We investigated CVC prevalence and conversion, and their effects on outcomes during the first year of HD in a multinational cohort of elderly patients. METHODS: Patients ≥70 years from the MONDO Initiative who commenced HD between 2000 and 2010 in Asia-Pacific, Europe, North-, and South-America and survived at least 6 months were included in this investigation...
2017: American Journal of Nephrology
https://www.readbyqxmd.com/read/28493896/candidemia-in-the-elderly-what-does-it-change
#15
Francesco Barchiesi, Elena Orsetti, Sara Mazzanti, Francesca Trave, Aldo Salvi, Cinzia Nitti, Esther Manso
BACKGROUND: Candidemia is a life-threatening fungal infection and it can affect patients of all ages. Characterization of candidemia in the elderly is lacking. METHODS: We performed a retrospective study of adults (≥ 18 years) with candidemia diagnosed in our center in 2010-2015. Demographics, comorbidities, clinical and microbiologic characteristics, antifungal treatment and outcome were compared between older (≤65 years) and younger (>65 years) patients...
2017: PloS One
https://www.readbyqxmd.com/read/28448971/pre-esrd-dementia-and-post-esrd-mortality-in-a-large-cohort-of-incident-dialysis-patients
#16
Miklos Z Molnar, Keiichi Sumida, Abduzhappar Gaipov, Praveen K Potukuchi, Tibor Fülöp, Kiran Joglekar, Jun Ling Lu, Elani Streja, Kamyar Kalantar-Zadeh, Csaba P Kovesdy
BACKGROUND: Conservative management may be a desirable option for elderly, fragile, or demented patients who reach end-stage renal disease (ESRD), yet some patients with dementia are placed on renal replacement therapy nonetheless. METHODS: From a nationwide cohort of 45,076 US veterans who transitioned to ESRD over 4 contemporary years (October 1, 2007 to September 30, 2011), we identified 1,336 (3.0%) patients with International Classification of Diseases, Ninth Revision, Clinical Modification code-based dementia diagnosis during the prelude (predialysis) period...
2017: Dementia and Geriatric Cognitive Disorders
https://www.readbyqxmd.com/read/28441373/cost-effectiveness-analysis-of-interventions-to-reduce-risk-of-aspiration-in-elderly-cancer-survivors-residing-in-skilled-nursing-facilities
#17
S Mantravadi
BACKGROUND: Aspiration can occur in patients of any age group, but it can be prevented. The primary population at risk is made up of survivors of cancer because of their increased risk of mucositis, mucosal atrophy, and dysphagia associated with chemotherapy, radiotherapy, and the disease process itself. The rate of incidence of aspiration cannot be quantified, because minor cases of aspiration often go unreported. Sequelae ensuing from aspirations can include pneumonia, end-stage kidney disease, dialysis, and death...
April 2017: Cancer Control: Journal of the Moffitt Cancer Center
https://www.readbyqxmd.com/read/28429551/the-role-of-calcium-and-non-calcium-based-phosphate-binders-in-chronic-kidney-disease
#18
Grahame J Elder, Jacqueline Center
Rising levels of serum phosphate occur late in the course of chronic kidney disease (CKD) and have been easy targets for nephrologists to treat using phosphate binding drugs, as well as fertile ground for the pharmaceutical industry, for meta-analysis and for the earnest pontifications of guideline writers. Unfortunately, the evidence does little to support this focus, which might be better applied to earlier, adaptive hormonal changes, and to phosphate balance rather than serum phosphate levels. Nevertheless, phosphate binders are ubiquitously prescribed to patients on dialysis, and often prescribed to patients with earlier stages of CKD; for which there is no evidence of benefit and some evidence that calcium-based binders (CBBs) and possibly non-CBBs may cause more harm than placebo...
March 2017: Nephrology
https://www.readbyqxmd.com/read/28414758/early-dialysis-initiation-does-not-improve-clinical-outcomes-in-elderly-end-stage-renal-disease-patients-a-multicenter-prospective-cohort-study
#19
MULTICENTER STUDY
Jae Yoon Park, Kyung Don Yoo, Yong Chul Kim, Dong Ki Kim, Kwon Wook Joo, Shin-Wook Kang, Chul Woo Yang, Nam-Ho Kim, Yong-Lim Kim, Chun-Soo Lim, Yon Su Kim, Jung Pyo Lee
BACKGROUND: The optimal timing for initiating dialysis in end-stage renal disease (ESRD) is controversial, especially in the elderly. METHODS: 665 patients ≥65 years old who began dialysis from August 2008 to February 2015 were prospectively enrolled in the Clinical Research Center for End-Stage Renal Disease cohort study. Participants were divided into 2 groups based on the median estimated glomerular filtration rate at the initiation of dialysis. Propensity score matching (PSM) was used to compare the overall survival rate, cardiovascular events, Kidney Disease Quality of Life Short Form 36 (KDQOL-36) results, Karnofsky performance scale values, Beck's depression inventory values, and subjective global assessments...
2017: PloS One
https://www.readbyqxmd.com/read/28407764/severe-hypertriglyceridemia-secondary-to-venlafaxine-use-in-an-older-adult-on-dialysis-case-report
#20
Hsiang-Wen Lin, Cory A Simonavice, Chiung-Ray Lu, Wen-Ling Lin, Po-Lun Wu, Che-Yi Chou, Chun-Hui Liao, Hsieh-Yuan Lane
BACKGROUND: Although the prescribing information for Venlafaxine extended release includes a discussion about possible increases in total cholesterol and triglycerides (TG) seen in healthier adult patients during premarketing clinical trials, no post-marketing studies or case reports, that discuss the effects of venlafaxine on TG in elderly patients with chronic kidney disease. CASE PRESENTATION: We report a 71 year-old male patient with end-stage renal disease on hemodialysis, with a history of coronary artery disease, mild hyperlipidemia, and hypertension...
April 13, 2017: BMC Health Services Research
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