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Elderly dialysis

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https://www.readbyqxmd.com/read/29316901/dialysis-facility-staff-perceptions-of-racial-gender-and-age-disparities-in-access-to-renal-transplantation
#1
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
https://www.readbyqxmd.com/read/29282632/effects-of-cilostazol-and-renin-angiotensin-system-ras-blockers-on-the-renal-disease-progression-of-korean-patients-a-retrospective-cohort-study
#2
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
https://www.readbyqxmd.com/read/29258464/evaluation-of-unplanned-dialysis-as-a-predictor-of-mortality-in-elderly-dialysis-patients-a-retrospective-data-analysis
#3
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
https://www.readbyqxmd.com/read/29248567/-when-less-is-more-optimising-care-for-elderly-patients-failing-to-thrive-on-dialysis
#4
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
https://www.readbyqxmd.com/read/29226654/evaluation-of-hepcidin-and-atherosclerosis-in-dialysis-patients
#5
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
https://www.readbyqxmd.com/read/29226070/economic-burden-of-community-acquired-pneumonia-among-elderly-patients-a-japanese-perspective
#6
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
https://www.readbyqxmd.com/read/29212466/exploring-the-use-of-tablet-computer-based-electronic-data-capture-system-to-assess-patient-reported-measures-among-patients-with-chronic-kidney-disease-a-pilot-study
#7
Dorothy Wong, Shen Cao, Heather Ford, Candice Richardson, Dmitri Belenko, Evan Tang, Luca Ugenti, Eleanor Warsmann, Amanda Sissons, Yalinie Kulandaivelu, Nathaniel Edwards, Marta Novak, Madeline Li, Istvan Mucsi
BACKGROUND: Collecting patient reported outcome measures (PROMs) via computer-based electronic data capture system may improve feasibility and facilitate implementation in clinical care. We report our initial experience about the acceptability of touch-screen tablet computer-based, self-administered questionnaires among patients with chronic kidney disease (CKD), including stage 5 CKD treated with renal replacement therapies (RRT) (either dialysis or transplant). METHODS: We enrolled a convenience sample of patients with stage 4 and 5 CKD (including patients on dialysis or after kidney transplant) in a single-centre, cross-sectional pilot study...
December 6, 2017: BMC Nephrology
https://www.readbyqxmd.com/read/29208453/comparison-of-survival-between-hemodialysis-and-peritoneal-dialysis-patients-with-end-stage-renal-disease-in-the-era-of-icodextrin-treatment
#8
I-Kuan Wang, Cheng-Li Lin, Tzung-Hai Yen, Shih-Yi Lin, Fung-Chang Sung
BACKGROUND: Icodextrin could reduce the risk of technique failure and improve patient survival in peritoneal dialysis (PD) patients. This study compared the survival between incident hemodialysis (HD) and PD patients, with and without diabetes, in the era of icodextrin treatment. METHODS: From the Taiwan health insurance database, 53,103 incident end-stage renal disease patients undergoing dialysis were identified from 2005 to 2010. The mortality risks among HD and PD patients with or without icodextrin treatment were compared...
December 3, 2017: European Journal of Internal Medicine
https://www.readbyqxmd.com/read/29173815/-focusing-on-kidney-transplantation-in-the-elderly
#9
Mathilde Lemoine, Dominique Guerrot, Dominique Bertrand
Due to the increase in life expectancy and the ageing of end-stage renal disease patients, the number of patients older than 65 years receiving a kidney transplant has been continuously growing over the last fifteen years. The benefits of renal transplantation compared to dialysis in terms of survival and quality of life have been shown in selected recipients over 65, or 70 years. However, the age remains the main limiting factor for the access to the waiting list, and the reluctance of the clinicians can be explained by the multiple comorbidities of these candidates, their limited life expectancy or the shortage of grafts...
November 21, 2017: Néphrologie & Thérapeutique
https://www.readbyqxmd.com/read/29169177/acute-kidney-injury-in-elderly-population-a-prospective-observational-study
#10
Cássia Gomes da Silveira Santos, Rafael Fernandes Romani, Ricardo Benvenutti, João Otávio Ribas Zahdi, Miguel Carlos Riella, Marcelo Mazza do Nascimento
BACKGROUND/AIMS: Acute kidney injury (AKI) has been reported as a recognized condition among the elderly population; however, its clinical epidemiology is still poorly evaluated. We propose to evaluate the epidemiological profile of AKI in hospitalized elderly patients and the variables associated with renal replacement therapy (RRT) dependency at discharge after an episode of AKI. METHODS: This prospective observational study enrolled 286 elderly patients (aged ≥60 years), who had a diagnosis of AKI and were admitted to a tertiary care hospital...
November 23, 2017: Nephron
https://www.readbyqxmd.com/read/29165139/analysis-of-the-evidence-practice-gap-to-facilitate-proper-medical-care-for-the-elderly-investigation-using-databases-of-utilization-measures-for-national-database-of-health-insurance-claims-and-specific-health-checkups-of-japan-ndb
#11
Takeo Nakayama, Yuichi Imanaka, Yasushi Okuno, Genta Kato, Tomohiro Kuroda, Rei Goto, Shiro Tanaka, Hiroshi Tamura, Shunichi Fukuhara, Shingo Fukuma, Manabu Muto, Motoko Yanagita, Yosuke Yamamoto
As Japan becomes a super-aging society, presentation of the best ways to provide medical care for the elderly, and the direction of that care, are important national issues. Elderly people have multi-morbidity with numerous medical conditions and use many medical resources for complex treatment patterns. This increases the likelihood of inappropriate medical practices and an evidence-practice gap. The present study aimed to: derive findings that are applicable to policy from an elucidation of the actual state of medical care for the elderly; establish a foundation for the utilization of National Database of Health Insurance Claims and Specific Health Checkups of Japan (NDB), and present measures for the utilization of existing databases in parallel with NDB validation...
June 6, 2017: Environmental Health and Preventive Medicine
https://www.readbyqxmd.com/read/29142957/identifying-factors-that-influence-physicians-recommendations-for-dialysis-and-conservative-management-in-indonesia
#12
Eric A Finkelstein, Semra Ozdemir, Chetna Malhotra, Tazeen H Jafar, Hui Lin Choong, Johnny Suhardjono
Introduction: For elderly end-stage renal disease (ESRD) patients with multiple comorbidities, dialysis may offer little survival benefit compared to conservative management (CM). Yet, many elderly ESRD patients undergo dialysis, partly due to physicians' recommendations regarding treatment choice. This study aims to elucidate the factors that influence these recommendations. Methods: We surveyed a convenience sample of physicians who attended the 9th Asian Forum of Chronic Kidney Disease Initiative conference...
March 2017: KI Reports
https://www.readbyqxmd.com/read/29133323/characteristics-and-healthcare-utilisation-patterns-of-high-cost-beneficiaries-in-the-netherlands-a-cross-sectional-claims-database-study
#13
Joost Johan Godert Wammes, Marit Tanke, Wilma Jonkers, Gert P Westert, Philip Van der Wees, Patrick Pt Jeurissen
OBJECTIVE: To determine medical needs, demographic characteristics and healthcare utilisation patterns of the top 1% and top 2%-5% high-cost beneficiaries in the Netherlands. DESIGN: Cross-sectional study using 1 year claims data. We broke down high-cost beneficiaries by demographics, the most cost-incurring condition per beneficiary and expensive treatment use. SETTING: Dutch curative health system, a health system with universal coverage...
November 12, 2017: BMJ Open
https://www.readbyqxmd.com/read/29108369/nephroureterectomy-increase-5-year-survival-in-patients-on-dialysis-with-upper-urinary-tract-urothelial-carcinoma
#14
Cih-En Huang, Yao-Hsu Yang, Wen-Cheng Chen, Kuo-Tsai Huang, Pau-Chung Chen, Ying-Huang Tsai, Wei-Yu Lin
Background: There is a high incidence rate of upper tract urothelial carcinoma (UTUC) in patients on dialysis. However, the studies about nephroureterectomy (NU) in this high surgical risk group are limited. The aim of this study is to investigate the outcomes of NU in this population. Results: There were total 931 patients enrolled and 218, 582, 131 patients were non-NU, unilateral and one-stage bilateral NU, respectively. NU provided better 5-year overall survival (66% versus 51% in non-NU, P = 0...
October 3, 2017: Oncotarget
https://www.readbyqxmd.com/read/29101991/acr-appropriateness-criteria%C3%A2-renovascular-hypertension
#15
Howard J Harvin, Nupur Verma, Paul Nikolaidis, Michael Hanley, Vikram S Dogra, Stanley Goldfarb, John L Gore, Stephen J Savage, Michael L Steigner, Richard Strax, Myles T Taffel, Jade J Wong-You-Cheong, Don C Yoo, Erick M Remer, Karin E Dill, Mark E Lockhart
Renovascular hypertension is the most common type of secondary hypertension and is estimated to have a prevalence between 0.5% and 5% of the general hypertensive population, and an even higher prevalence among patients with severe hypertension and end-stage renal disease, approaching 25% in elderly dialysis patients. Investigation for renal artery stenosis is appropriate when clinical presentation suggests secondary hypertension rather than primary hypertension, when there is not another known cause of secondary hypertension, and when intervention would be carried out if a significant renal artery stenosis were identified...
November 2017: Journal of the American College of Radiology: JACR
https://www.readbyqxmd.com/read/29096710/putting-research-in-place-an-innovative-approach-to-providing-contextualized-evidence-synthesis-for-decision-makers
#16
Stephen Bornstein, Rochelle Baker, Pablo Navarro, Sarah Mackey, David Speed, Melissa Sullivan
BACKGROUND: The Contextualized Health Research Synthesis Program (CHRSP), developed in 2007 by the Newfoundland and Labrador Centre for Applied Health Research, produces contextualized knowledge syntheses for health-system decision makers. The program provides timely, relevant, and easy-to-understand scientific evidence; optimizes evidence uptake; and, most importantly, attunes research questions and evidence to the specific context in which knowledge users must apply the findings. METHODS: As an integrated knowledge translation (KT) method, CHRSP: Involves intensive partnerships with senior healthcare decision makers who propose priority research topics and participate on research teams; Considers local context both in framing the research question and in reporting the findings; Makes economical use of resources by utilizing a limited number of staff; Uses a combination of external and local experts; and Works quickly by synthesizing high-level systematic review evidence rather than primary studies...
November 2, 2017: Systematic Reviews
https://www.readbyqxmd.com/read/29067226/dialysis-a-review-of-the-mechanisms-underlying-complications-in-the-management-of-chronic-renal-failure
#17
REVIEW
Sabitha Vadakedath, Venkataramana Kandi
Chronic renal failure (CRF) is the most prevalent, worldwide public health problem of the elderly population. The main cause of CRF is a damaged kidney. There are five stages of CRF based on the glomerular filtration rate (GFR), and stage 5 (GFR < 15 ml/min/1.73m(2)) is often called an end-stage renal disease (ESRD). In CRF, there is an accumulation of toxins and excess water due to compromised renal function. Dialysis is the preferred way to treat ESRD and remove accumulated toxins from the body. The cardiovascular risk associated with dialysis is 10 to 20 times higher in patients undergoing dialysis than in normal people...
August 23, 2017: Curēus
https://www.readbyqxmd.com/read/29064141/the-role-of-dietary-phosphate-restriction-in-chronic-kidney-disease
#18
Grahame J Elder, Avya Malik, Kelly Lambert
BACKGROUND AND OBJECTIVES: Patients with progressive chronic kidney disease (CKD) develop positive phosphate balance that is associated with increased cardiovascular risk and mortality. Modification of dietary phosphate is a commonly used strategy to improve outcomes but is complicated by the need for adequate dietary protein. Surprisingly, the evidence for patient-level benefits from phosphate restriction is tenuous, and the justification for using any phosphate binder for pre-dialysis patients is questionable...
October 24, 2017: Nephrology
https://www.readbyqxmd.com/read/29046987/blood-pressure-parameters-and-their-associations-with-death-in-patients-with-chronic-kidney-disease
#19
REVIEW
Samaya Qureshi, Robert Lorch, Sankar D Navaneethan
PURPOSE OF REVIEW: Optimal blood pressure (BP) parameters among patients with chronic kidney disease (CKD) have been a matter of debate. This review critically evaluates recent literature to better define the associations of BP parameters and death among individuals with non-dialysis-dependent CKD. RECENT FINDINGS: Observational studies report a "U- or J-shaped" association between BP and all-cause mortality in CKD and caution-intensive BP lowering in the elderly...
October 18, 2017: Current Hypertension Reports
https://www.readbyqxmd.com/read/29044336/the-impact-of-body-mass-index-bmi-variation-on-mortality-of-incident-elderly-patients-on-peritoneal-dialysis-a-joint-model-analysis
#20
Marcia Regina Gianotti Franco, Fernando Antonio Basile Colugnati, Abdul Rashid Qureshi, José Carolino Divino-Filho, Natália Maria Da Silva Fernandes
INTRODUCTION: Data on impact of high body mass index (BMI) on mortality of patients on peritoneal dialysis (PD), especially among elderly, are inconsistent. Objective: To evaluate impact of BMI on cohort of incident elderly PD patients over time. METHODS: Prospective multicenter cohort study (December / 2004-October/2007) with 674 patients. Socio-demographic and clinical data evaluated with patients followed until death, transfer to hemodialysis (HD), recovery of renal function, loss of follow-up or transplant...
July 2017: Jornal Brasileiro de Nefrologia: ʹorgão Oficial de Sociedades Brasileira e Latino-Americana de Nefrologia
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