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Elderly dialysis

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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
#1
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
#2
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
#3
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
#4
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
#5
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
#6
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
#7
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
#8
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
#9
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
#10
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
#11
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
#12
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
https://www.readbyqxmd.com/read/28072755/strategies-for-an-expanded-use-of-kidneys-from-elderly-donors
#13
María José Pérez-Sáez, Nuria Montero, Dolores Redondo-Pachón, Marta Crespo, Julio Pascual
The old-for-old allocation policy used for kidney transplantation (KT) has confirmed the survival benefit compared to remaining listed on dialysis. Shortage of standard donors has stimulated the development of strategies aimed to expand acceptance criteria, particularly of kidneys from elderly donors. We have systematically reviewed the literature on those different strategies. In addition to the review of outcomes of expanded criteria donor (ECD) or advanced age kidneys, we assessed the value of the Kidney Donor Profile Index (KDPI) policy, preimplantation biopsy, dual KT, machine perfusion and special immunosuppressive protocols...
January 9, 2017: Transplantation
https://www.readbyqxmd.com/read/28062418/103-year-old-on-dialysis-was-it-worth-it
#14
Alvin Shrestha, Aine Burns
It is increasingly common for nephrologists to be faced with the question of whether starting dialysis on an elderly patient is appropriate. We present an extraordinary case of a 103-year-old person who has become the oldest patient in our unit, reportedly the world, to not only remain on haemodialysis, but to thrive on it. This case adds to the compelling literature, which suggests that it is indeed the number and severity of comorbidities that is more likely to impact survival than age alone.
January 6, 2017: BMJ Case Reports
https://www.readbyqxmd.com/read/28033185/use-of-the-body-composition-monitor-for-fluid-status-measurements-in-elderly-malnourished-subjects
#15
David F Keane, Kim Bowra, Kathryn Kearney, Elizabeth Lindley
Most haemodialysis (HD) patients are able to finish dialysis at or below the normally hydrated weight determined using the body composition monitor (BCM). However, a minority become symptomatic when they are still fluid overloaded based on BCM-measured overhydration (OH). Malnourished patients frequently fall into this group, suggesting that they may have OH that is inaccessible to ultrafiltration. To isolate any effect of malnutrition on BCM-measured OH from those relating to renal failure, OH measurements for twenty elderly subjects with normal renal function who were classified as malnourished were compared with an age-matched cohort with no known nutritional issues...
December 26, 2016: ASAIO Journal: a Peer-reviewed Journal of the American Society for Artificial Internal Organs
https://www.readbyqxmd.com/read/28031705/earlier-nephrology-consultation-may-not-be-associated-with-improved-short-term-survival-of-acute-kidney-injury-in-very-elderly-men
#16
Qinglin Li, Meng Zhao, Jing Du, Xiaodan Wang
OBJECTIVES: A delayed nephrology consultation (NC) may be associated with a poor prognosis in acute kidney injury (AKI) patients. The aims of this study were to compare the clinical and laboratory characteristics of elderly AKI patients evaluated and not evaluated by nephrologists and to generate a hypothesis regarding the relationship between the timing of the NC and 90-day outcomes. METHODS: From 2007 to 2015, this study explored associations among the presence and timing of NC with the non-intensive care unit stay and 90-day mortality in elderly AKI patients at the Geriatric Department of the Chinese People's Liberation Army General Hospital...
2017: Clinical Interventions in Aging
https://www.readbyqxmd.com/read/28027805/variations-in-outcomes-of-hemodialysis-vascular-access-by-race-ethnicity-in-the-elderly
#17
Karen Woo, Laura Gascue, Dana P Goldman, John A Romley
OBJECTIVE: Prevalence of end-stage renal disease, modality of treatment, and type of hemodialysis vascular access used varies widely by race/ethnicity in the United States, but outcomes of hemodialysis vascular access by race/ethnicity are poorly described. The objective of this study is to evaluate variations in outcomes of hemodialysis vascular access in the elderly by race/ethnicity. METHODS: Medicare outpatient, inpatient, and carrier files were queried from 2006 to 2011 for beneficiaries that were age ≥66 years and dialysis-dependent at time of index fistula/graft creation, qualified for Medicare by age only, and were continuously enrolled in Medicare 12 months before and after index fistula/graft creation...
December 24, 2016: Journal of Vascular Surgery
https://www.readbyqxmd.com/read/28012729/neurologic-emergencies-in-hiv-negative-immunosuppressed-patients
#18
J A Guzmán-De-Villoria, P Fernández-García, P J Borrego-Ruiz
HIV-negative immunosuppressed patients comprise a heterogeneous group including transplant patients, patients undergoing treatment with immunosuppressors, uremic patients, alcoholics, undernourished patients, diabetics, patients on dialysis, elderly patients, and those diagnosed with severe or neoplastic processes. Epileptic seizures, focal neurologic signs, and meningoencephalitis are neurologic syndromes that require urgent action. In most of these situations, neuroimaging tests are necessary, but the findings can be different from those observed in immunocompetent patients in function of the inflammatory response...
December 21, 2016: Radiología
https://www.readbyqxmd.com/read/27999960/quality-of-life-of-elderly-patients-on-peritoneal-dialysis-versus-hemodialysis-a-single-center-study
#19
Yosuke Saka, Tomohiko Naruse, Naoto Tawada, Mitsuhiro Tokomoto, Yuhei Noda, Yohei Taniguchi, Yasuko Nagahara, Ryoko Yamashita, Munetoshi Karasawa, Yuzo Watanabe, Yasuhiko Ito
BACKGROUND: The number of elderly dialysis patients in Japan is dramatically increasing. Receiving therapy with better satisfaction through home care is one of the important factors in their daily lives. Thus, the quality of life of elderly patients on hemodialysis (HD) or peritoneal dialysis (PD) was evaluated. METHODS: Clinical information of patients aged ≥80 years who started dialysis at our hospital between January 2013 and December 2015 was retrospectively collected...
December 20, 2016: Clinical and Experimental Nephrology
https://www.readbyqxmd.com/read/27994865/morbidity-mortality-and-quality-of-life-in-the-ageing-haemodialysis-population-results-from-the-elderly-study
#20
Joerg Seckinger, Wilfried Dschietzig, Gerd Leimenstoll, Peter M Rob, Martin K Kuhlmann, Wolfgang Pommer, Uwe Fraass, Eberhard Ritz, Vedat Schwenger
BACKGROUND: The physical-functional and social-emotional health as well as survival of the elderly (≥75 years of age) haemodialysis patient is commonly thought to be poor. In a prospective, multicentre, non-interventional, observational study, the morbidity, mortality and quality of life (QoL) in this patient group were examined and compared with a younger cohort. METHODS: In 92 German dialysis centres, 2507 prevalent patients 19-98 years of age on haemodialysis for a median of 19...
December 2016: Clinical Kidney Journal
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