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End stage kidney AND elderly

Julia Brodski, Susan L Rossell, David J Castle, Eric J Tan
OBJECTIVES: Recognition of cognitive impairment in chronic kidney disease (CKD) and its impact on functioning in adults is growing. The vast majority of studies to date have been conducted in older populations where CKD is more pronounced; however, the degree to which age-related cognitive changes could be influencing these findings remains unaddressed. This current study thus aimed to review cognitive impairment findings by stage in non-elderly CKD samples. METHODS: PubMed and Medline via Scopus were searched for cross-sectional or cohort studies and randomized controlled trials that assessed cognitive function in individuals with CKD in any research setting...
November 22, 2018: Journal of the International Neuropsychological Society: JINS
Daiki Watanabe, Shinji Machida, Naoki Matsumoto, Yugo Shibagaki, Tsutomu Sakurada
Whether the effect of a low-protein diet on progression to end-stage renal disease (ESRD) and mortality risk differs between young and elderly adults with chronic kidney disease (CKD) is unclear. We conducted a retrospective CKD cohort study to investigate the association between protein intake and mortality or renal outcomes and whether age affects this association. The cohort comprised 352 patients with stage G3-5 CKD who had been followed up for a median 4.2 years, had undergone educational hospitalization, and for whom baseline protein intake was estimated from 24-h urine samples...
November 13, 2018: Nutrients
Namiko A Goto, Ismay N van Loon, Moira I Morpey, Marianne C Verhaar, Hanna C Willems, Mariëlle H Emmelot-Vonk, Michiel L Bots, Franciscus T J Boereboom, Marije E Hamaker
BACKGROUND/AIMS: Decision-making in elderly patients considering dialysis is highly complex. With the increasing number of elderly with end-stage kidney disease (ESKD), it may be important to assess geriatric impairments in this population. The aim of the Geriatric assessment in OLder patients starting Dialysis (GOLD) study was to assess the prevalence of geriatric impairments and frailty in the elderly ESKD population by means of a geriatric assessment (GA), which is a comprehensive tool for overall health assessment...
November 1, 2018: Nephron
Akihiro Kosoku, Junji Uchida, Kazuya Kabei, Shunji Nishide, Hisao Shimada, Tomoaki Iwai, Nobuyuki Kuwabara, Toshihide Naganuma, Keiko Maeda, Norihiko Kumada, Yoshiaki Takemoto, Tatsuya Nakatani
BACKGROUND: The growth in the end-stage kidney disease (ESKD) population has been predominantly in the older adult population. In Japan, ABO-incompatible kidney transplantation has become an acceptable treatment option. However, few studies have been conducted on elderly ABO-incompatible kidney transplantation. PATIENTS AND METHODS: Seventeen patients aged 60 years and older who received their grafts from ABO-incompatible living donors at our institution between December 2006 and September 2016 were enrolled in this study, and the outcome of these recipients was evaluated...
2018: Urologia Internationalis
Shutaro Futami, Joji Ishikawa, Yukari Arima, Yukiko Mogami, Yoshiko Nemoto, Jun Tanaka, Eiichi Saito, Kazumasa Harada
It is difficult to manage the symptoms of patients who are dying of end-stage heart failure (HF). Opioids are sometimes required to relieve their symptoms in addition to oxygen therapy and medical management. Oxycodone is a μ receptor agonist that is known to be a safer opioid than morphine in patients with chronic kidney disease (CKD) because its metabolites have weak pharmacological activity. We treated a 99-year-old woman who had end-stage HF (secondary to severe aortic stenosis) and CKD. It was also difficult to maintain an intravenous line because of severe edema...
June 2018: Journal of Cardiology Cases
Chih-Cheng Lai, Che-Hsiung Wu, Ya-Hui Wang, Cheng-Yi Wang, Vin-Cent Wu, Likwang Chen
Objective: The aim of this study was to investigate the impact of COPD on the outcomes of patients with advanced chronic kidney disease (CKD). Patients and methods: All patients with advanced CKD from 2000 to 2010 were identified from the Taiwanese National Health Insurance Research Database. Associations between COPD and the risk of long-term dialysis and all-cause mortality were assessed. Results: A total of 33,399 advanced CKD patients were enrolled, of whom 31,536 did not have COPD (non-COPD group) and 1,863 had COPD (COPD group)...
2018: International Journal of Chronic Obstructive Pulmonary Disease
Kyung Soo Kim, Seok Won Park, Yong Wook Cho, Soo Kyung Kim
BACKGROUND: To evaluate the prevalence of chronic kidney disease (CKD) and progression rate to CKD in elderly patients with type 2 diabetes mellitus (T2DM). METHODS: We investigated the medical records of 190 elderly patients (65 years or older) with T2DM from 2005 to 2011 in 6-month increments. Mean follow-up duration was 64.5 months. CKD was defined as estimated glomerular filtration rate (eGFR) <60 mL/min/1.73 m² and/or the presence of albuminuria. RESULTS: The mean age was 70...
May 31, 2018: Diabetes & Metabolism Journal
Hiroyuki Ueda, Yoichi Miyazaki, Nobuo Tsuboi, Keita Hirano, Shinya Yokote, Emi Kobayashi, Makoto Ogura, Tetsuya Kawamura, Munekazu Ryuzaki, Takashi Yokoo
Objective This case series aimed to identify the clinical and pathological characteristics of elderly patients (≥60 years) with biopsy-proven IgA vasculitis with nephritis (IgAVN). Methods The clinical and pathological presentation and treatment outcomes were compared between two groups. Patients Patients with IgAVN who were ≥19 years old at the time of their renal biopsy were divided into elderly (≥60 years) and adult (19-59 years) groups. Results Of the 23 patients in our study, 13 were elderly. In the elderly group, the median age at the diagnosis was 68 years (range, 60-85 years), with a median follow-up period of 15 months (range, 3-80 months)...
August 10, 2018: Internal Medicine
Eun Jin Kim, Woonji Lee, Woo Yong Jeong, Hen Choi, In Young Jung, Jin Young Ahn, Su Jin Jeong, Nam Su Ku, Jun Yong Choi, Young Hwa Choi, Young Goo Song, June Myung Kim
BACKGROUND: Genitourinary tuberculosis (GUTB) is a type of extrapulmonary TB that exerts a deleterious effect on renal function by promoting renal calcification and ureteric stricture. Therefore, we investigated the risk factors for chronic kidney disease (CKD) in GUTB patients after the end of treatment. METHODS: This retrospective study was conducted at a tertiary hospital in South Korea. Data from patients (>18 years of age) with GUTB were collected from January 2005 to July 2016...
August 2, 2018: BMC Nephrology
M Yang, Y-H Bai, J-S Wang, H-Y Jiang, S-L Hu
OBJECTIVE: Elderly uremia frequently refers to the end stage of various chronic kidney diseases that threats the patients' health seriously. Enteral nutrition can reduce complications, while the molecular mechanism is still unclear. Mitochondrial protein Bim plays an essential role in regulating inflammation, restraining oxidative stress, and maintaining the balance of the mitochondrial membrane potential and energy production. This study aims to investigate the effect of Bim on the early diagnosis and prognosis of the elderly uremia with gastrointestinal nutrition combined with dialysis...
July 2018: European Review for Medical and Pharmacological Sciences
Michele Provenzano, Paolo Chiodini, Roberto Minutolo, Carmine Zoccali, Vincenzo Bellizzi, Giuseppe Conte, Francesco Locatelli, Giovanni Tripepi, Lucia Del Vecchio, Francesca Mallamaci, Lucia Di Micco, Domenico Russo, Hiddo J L Heerspink, Luca De Nicola
Background: In non-dialysis chronic kidney disease (CKD), absolute proteinuria (Uprot) depends on the extent of kidney damage and residual glomerular filtration rate (GFR). We therefore evaluated, as compared with Uprot, the strength of association of proteinuria indexed to estimated GFR (eGFR) with end-stage renal disease (ESRD) risk. Methods: In a multi-cohort prospective study in 3957 CKD patients of Stages G3-G5 referred to nephrology clinics, we tested two multivariable Cox models for ESRD risk, with either Uprot (g/24 h) or filtration-adjusted proteinuria (F-Uprot) calculated as Uprot/eGFR ×100...
July 23, 2018: Nephrology, Dialysis, Transplantation
Michael Stöckle, Kerstin Junker, Paolo Fornara
CONTEXT: Organ transplantation requires immunosuppression, which was regarded as a risk factor for tumor induction and tumor progression in all types of malignancy. Until recently, any form of active neoplasia was, therefore, regarded as contraindicative to organ transplantation. However, there is growing evidence that the increased tumor risk by immunosuppression is restricted to particular subgroups of malignancy, whereas others such as prostate cancer (PCa) are not negatively influenced...
March 2018: European Urology Focus
Takahisa Kawaguchi, Tadashi Yoshida, Junichi Hirahashi, Tomoko Uehara, Toshiki Takenouchi, Kenjiro Kosaki, Hiroshi Itoh, Matsuhiko Hayashi
Nephronophthisis-related ciliopathies (NPHP-RC) are autosomal recessive disorders characterized by renal corticomedullary cysts with the extrarenal symptoms. Typically, patients with NPHP-RC reach end-stage kidney disease (ESKD) before the age of 30 years. We herein report a Japanese woman with NPHP-RC who had unusually delayed progression to ESKD after 6 decades. She exhibited liver dysfunction at the age of 23 years. She also showed mild renal dysfunction at the age of 43 years. Ultrasonography revealed bilateral multiple renal cysts with loss of corticomedullary differentiation...
2018: Nephron
Rune Bjørneklett, Leif Bostad, Anne-Siri Fismen
Background: The value of a histologic classification scheme to classify patients with anti-neutrophil cytoplasmic antibody-associated glomerulonephritis (ANCA-GN) into focal, mixed, crescentic, and sclerotic types for predicting risk of end-stage renal disease (ESRD) is well documented. However, the prognostic value of histological classification specifically in elderly patients (≥70 years) with ANCA-GN has not previously been investigated. Methods: Patients with biopsy-verified pauci-immune necrotizing glomerulonephritis were identified from the Norwegian Kidney Biopsy Registry between 1991 and 2012 and those ≥70 years of age at the time of diagnosis and having positive anti-neutrophil cytoplasmic antibody serology were included in this study...
2018: BioMed Research International
Oscar K Serrano, Kunal Yadav, Ananta Bangdiwala, David M Vock, Ty B Dunn, Erik B Finger, Timothy L Pruett, Arthur J Matas, Raja Kandaswamy
With increasing organ demand, living kidney donation from older donors (>60-years-old) has become more common. Between 1975 and 2014, 3752 donor nephrectomies (DN) were performed at University of Minnesota; 167 (4.5%) were >60-years-old Short- and long-term outcomes were compared between contemporaneous >60-years-old and <60-years-old donors. On univariate analysis, >60-years-old were more likely to have had prior abdominal surgery and hypertension; and less likely to smoke. Baseline estimated glomerular filtration rate (eGFR) was lower in >60-years-old (80 ± 16 vs 101 ± 26 mL/min/1...
August 2018: Clinical Transplantation
Ashish K Sharma, Nigel D Toussaint, Grahame J Elder, Rosemary Masterson, Stephen G Holt, Patricia L Robertson, Peter R Ebeling, Paul Baldock, Rhiannon C Miller, Chamith S Rajapakse
BACKGROUND: Chronic kidney disease (CKD) adversely affects bone microarchitecture and increases fracture risk. Historically, bone biopsy has been the 'gold standard' for evaluating renal bone disease but is invasive and infrequently performed. High-resolution magnetic resonance imaging (MRI) quantifies bone microarchitecture noninvasively. In patients with CKD, it has not been compared with results derived from bone biopsy or with imaging using dual energy X-ray absorptiometry (DXA). METHODS: Fourteen patients with end-stage kidney disease (ESKD) underwent MRI at the distal tibia, bone mineral density (BMD) by dual energy X-ray absorptiometry (DXA; hip and spine) and transiliac bone biopsies with histomorphometry and microcomputed tomography (micro-CT)...
September 2018: Bone
Hiroyuki Komatsu, Shouichi Fujimoto, Shoichi Maruyama, Masashi Mukoyama, Hitoshi Sugiyama, Kazuhiko Tsuruya, Hiroshi Sato, Jun Soma, Junko Yano, Seiji Itano, Tomoya Nishino, Toshinobu Sato, Ichiei Narita, Hitoshi Yokoyama
BACKGROUND: The clinical presentation and prognosis of adult and elderly patients with IgA vasculitis (Henoch-Schönlein purpura) accompanied by nephritis (IgAV-N) have not been investigated in detail. We therefore surveyed the features and outcomes of IgAV-N based on nationwide data derived from the Japan Renal Biopsy Registry (J-RBR). METHODS: This multi-center cohort study compared the clinicopathological parameters at diagnosis, initial therapies and outcomes between 106 adult (age 19-64 years) and 46 elderly (≥65 years) patients with IgAV-N who were registered in the J-RBR between 2007 and 2012...
2018: PloS One
Edlyn Gui Fang Tan, Irene Teo, Eric A Finkelstein, Choong Meng Chan
BACKGROUND: In Singapore, most elderly end stage renal disease (ESRD) patients choose dialysis over palliative management. However, dialysis may not be the optimal treatment option given only moderate survival benefits and high costs and treatment burden compared to non-dialysis management. Elderly patients may therefore come to regret this decision. This study investigated (1) extent of patients' decision regret after starting dialysis, and (2) potentially modifiable predictors of regret: satisfaction with chronic kidney disease education, decisional conflict, and decision-making involvement...
May 7, 2018: Nephrology
Emily C Liang, Maura Rossetti, Tiffany Sidwell, Victoria Groysberg, Gema Sunga, Yael Korin, Sitaram Vangala, Basmah Abdalla, Erik Lum, Suphamai Bunnapradist, Phuong-Thu Pham, Gabriel Danovitch, Elaine F Reed, Joanna Schaenman
Background: The number of elderly patients with end-stage kidney disease requiring kidney transplantation continues to grow. Evaluation of healthy older adults has revealed proinflammatory changes in the immune system, which are posited to contribute to age-associated illnesses via "inflamm-aging." Immunologic dysfunction is also associated with impaired control of infections. Whether these immunologic changes are found in older kidney transplant recipients is not currently known, but may have important implications for risk for adverse clinical outcomes...
March 2018: Transplantation Direct
Keiji Tsuji, Masayuki Kurosaki, Jun Itakura, Nami Mori, Shintaro Takaki, Chitomi Hasebe, Takehiro Akahane, Kouji Joko, Hitoshi Yagisawa, Jirou Takezawa, Ryou Nakata, Atsunori Kusakabe, Yuji Kojima, Hiroyuki Kimura, Takashi Tamada, Haruhiko Kobashi, Akeri Mitsuda, Masahiko Kondou, Chikara Ogawa, Yasushi Uchida, Tetsuro Sohda, Ryouichi Narita, Namiki Izumi
BACKGROUND: We aimed to describe the real-world efficacy and safety of combination therapy with ledipasvir and sofosbuvir (LDV/SOF) for chronic hepatitis C virus (HCV) genotype 1 (GT1) infection. METHODS: This retrospective analysis of a prospective, nationwide, multicenter registry included GT1-infected patients treated with LDV/SOF for 12 weeks. We assessed the rate of sustained virological response at 12 weeks post-treatment (SVR12), incidence of adverse events, and serum markers of hepatocellular carcinoma (HCC)...
October 2018: Journal of Gastroenterology
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