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Chronic kidney disease in elderly

Olivier Moranne, Coraline Fafin, Sophie Roche, Maud Francois, Vincent Allot, Jerome Potier, Daniela Babici, Thierry Lobbedez, Marie Matignon, Christophe Mariat, Cecile Vigneau, Cecile Couchoud
Background: Elderly patients with advanced chronic kidney disease require accurate outcome descriptions to make treatment decisions. Methods: The PSPA [Parcours de soins des personnes âgées (Treatment pathways for elderly patients)] prospective multicentre cohort study included 573 such patients with a median age of 82 [interquartile range (IQR) 79-86] years and a median estimated glomerular filtration rate of 14 (IQR 11-17) mL/min/1.73 m2 and studied their 5-year outcomes according to the dialysis component of their treatment plans...
March 19, 2018: Nephrology, Dialysis, Transplantation
Irfanullah Khan, Amer Hayat Khan, Azreen Syazril Adnan, Syed Azhar Syed Sulaiman, Azhar Bin Amir Hamzah, Nafees Ahmed, Amjad Khan
PURPOSE: Creatinine is normally used to evaluate kidney function among elderly patients in clinical practice, which has been reported to be affected by socio-demographic factors like BMI and age. Cystatin C a newly introduced biomarker may be more efficient in identifying kidney function in obese and aged CKD patients. The aim of the current study was to assess the effect of BMI on endogenous biomarkers (cystatin C and creatinine) among elderly CKD patients in Malaysia, a first such study in the country...
March 13, 2018: International Urology and Nephrology
Bin Bai, Jiadela Teliewubai, Yuyan Lu, Shikai Yu, Jing Xiong, Chen Chi, Yiwu Zhou, Hongwei Ji, Ximin Fan, Jacques Blacher, Jue Li, Yi Zhang, Yawei Xu
This study aimed to investigate the discrepancy between pulse wave velocity (PWV) and pulse pressure amplification (PPA) in association with hypertensive target organ damage (TOD) in the elderly. From June 2014 to August 2015, 1599 participants aged >65 years old from communities located in northern Shanghai were recruited. Carotid-femoral pulse wave velocity (cfPWV), peripheral blood pressure (BP), central BP and other TOD indicators, including the ratio of the early ventricular filling velocity (E) to the peak velocity of the tissue Doppler velocity of septal mitral annulus (E/Ea), left ventricular mass index (LVMI), carotid intima-medium thickness (CIMT), estimated glomerular filtration rate (eGFR), and urinary albumin-creatinine ratio (ACR), were determined for each participant...
March 13, 2018: Hypertension Research: Official Journal of the Japanese Society of Hypertension
Seoyoung C Kim, Tuhina Neogi, Eun Ha Kang, Jun Liu, Rishi J Desai, MaryAnn Zhang, Daniel H Solomon
BACKGROUND: Patients with gout are at an increased risk of cardiovascular (CV) disease including myocardial infarction (MI), stroke, and heart failure (HF). OBJECTIVES: The authors conducted a cohort study to examine comparative CV safety of the 2 gout treatments-probenecid and allopurinol-in patients with gout. METHODS: Among gout patients ≥65 years of age and enrolled in Medicare (2008 to 2013), those who initiated probenecid or allopurinol were identified...
March 6, 2018: Journal of the American College of Cardiology
Clara J Bohm, Leroy J Storsley, Brett M Hiebert, Serena Nelko, Navdeep Tangri, Lawrence J Cheskin, Mara A McAdams-DeMarco, Claudio Rigatto
Background: Individuals with chronic kidney disease (CKD) have low levels of physical activity and physical function. Although guidelines endorse exercise counseling for individuals with CKD, it is not yet part of routine care. Objective: We investigated the effect of attending a real-life exercise counseling clinic (ECC) on physical function in individuals with CKD. Design: Retrospective analysis of prospectively collected observational data with quasi-experimental design...
2018: Canadian Journal of Kidney Health and Disease
Shuang Liang, Wen-Ling Wang, Fang-Lei Zhu, Shu-Wei Duan, Xue-Feng Sun, Xiang-Mei Chen, Guang-Yan Cai
INTRODUCTION: The proportion of elderly people is steadily rising worldwide, especially in low-income and middle-income countries, including China. Chronic kidney disease (CKD) is a common disorder in older people. However, little is known about the epidemiology of CKD and its consequences among the elderly. Improvements on clinical guidelines and healthcare policies for this population are required. This study aims to examine the risk factors for progression of CKD among the elderly and develop models to identify subgroups who are at high risk...
February 24, 2018: BMJ Open
P Zaoui, T Hannedouche, C Combe
Type 2 diabetes has an increasing prevalence. Life expectancy is dominated by cardiovascular risk, which is the leading cause of death in these patients. Up to one third of diabetic patients will develop diabetic nephropathy related to micro-angiopathy. Renal impairment further increases cardiovascular risk. Reducing cardiovascular morbidity and mortality is a major public health issue, as well as early preventing and managing chronic kidney disease (CKD). Good glycemic control prevents the micro-vascular complications of the disease (retinopathy, nephropathy, etc...
June 2017: Néphrologie & Thérapeutique
Frédéric Lapostolle, Virginie Siguret, Anne-Céline Martin, Claire Pailleret, Bernard Vigué, Yves Zerbib, Karim Tazarourte
The recent emergence of 'non-VKA' oral anticoagulants may have led to some forgetting that vitamin K antagonists (VKA) are by far the most widely prescribed oral anticoagulants worldwide. Consequently, we decided to summarize the information available on them. This paper presents the problems facing emergency physicians confronted with patients on VKAs in 10 points, from pharmacological data to emergency management. Vitamin K antagonists remain preferable in many situations including in the elderly, in patients with extreme body weights, severe chronic kidney or liver disease or valvular heart disease, and in patients taking VKAs with well-controlled international normalized ratios (INRs)...
February 16, 2018: European Journal of Emergency Medicine: Official Journal of the European Society for Emergency Medicine
Hatem Ali, Tarek Abdelaziz, Fatima Abdelaal, Jyoti Baharani
The relationship between frailty and chronic kidney disease in elderly population has been recognized; however, studies concentrating on frailty in predialysis patients are limited. For nephrologists, the recognition of frailty is important as it has impact on decisions on the choice of dialysis modality and sometimes on whether dialysis is indeed in the patients' best interests. Many of the tools for routine assessment of frailty are not easily applicable to those clinicians not practicing elderly care medicine...
January 2018: Saudi Journal of Kidney Diseases and Transplantation
Kristian Heldal, Karsten Midtvedt, Anders Hartmann, Anna Varberg Reisaeter, Torbjørn Fossum Heldal, Stein Bergan, Cathrin Lytomt Salvador, Anders Åsberg
Several equations have been developed for estimated glomerular filtration rate (eGFR) in patients with chronic kidney disease (CKD), but none were developed based on data from elderly kidney transplant recipients (KTR). The primary aim of this study was to evaluate different creatinine based equations in stable elderly KTR. A national cross-sectional study was performed using data from 263 consecutive kidney transplant recipients 60 years or older who performed a routine GFR measurement one year after engraftment...
February 17, 2018: Transplant International: Official Journal of the European Society for Organ Transplantation
Naseer Ahmed, Yong Choe, Vikkie A Mustad, Sumita Chakraborty, Scott Goates, Menghua Luo, Jeffrey I Mechanick
Objective: The aim of this study was to examine the impact of pre-existing malnutrition on survival and economic implications in elderly patients with diabetes. Research design and methods: A retrospective observational study was conducted to examine the impact of malnutrition with or without other significant health conditions on survival time and healthcare costs using the Centers for Medicare and Medicaid Services (CMS) data from 1999 to 2014 for beneficiaries with a confirmed first date of initial diagnosis of diabetes (n=15 121 131)...
2018: BMJ Open Diabetes Research & Care
Abhilash Koratala, Jogiraju Tantravahi
Chronic kidney disease and acute kidney injury are being increasingly recognized in very elderly patients, aged 80 or more. In cases of suspected glomerulonephritis with or without nephrotic syndrome, the clinical decision-making of whether to obtain a renal biopsy and treat with immunosuppressive therapy should not be based on advanced age alone but take into consideration the patient's functional status and overall prognosis. Herein, we report a case of an elderly patient with minimal change disease who benefitted from a timely renal biopsy and aggressive immunosuppressive therapy...
January 8, 2018: Clinics and Practice
Grace M Turner, Melanie Calvert, Max G Feltham, Ronan Ryan, Samuel Finnikin, Tom Marshall
BACKGROUND AND PURPOSE: Primary prevention of stroke and transient ischemic attack (TIA) is important to reduce the burden of these conditions; however, prescribing of prevention drugs is suboptimal. We aimed to identify individual clinical and demographic characteristics associated with potential missed opportunities for prevention therapy with lipid-lowering, anticoagulant, or antihypertensive drugs before stroke/TIA. METHODS: We analyzed anonymized electronic primary care records from a UK primary care database that covers 561 family practices...
February 13, 2018: Stroke; a Journal of Cerebral Circulation
Juan Martínez Candela, Javier Sangrós González, Francisco Javier García Soidán, José Manuel Millaruelo Trillo, Javier Díez Espino, Daniel Bordonaba Bosque, Luis Ávila Lachica
INTRODUCTION: Type 2 diabetes mellitus and chronic kidney disease (CKD) are conditions which have a high prevalence in individuals ≥ 65 years of age and represent a major public health problem. OBJECTIVES: To determine the prevalence of CKD, its categories and its relationship with various demographic and clinical factors in elderly patients with type 2 diabetes mellitus in Spain. METHODS: Observational, cross-sectional, multicenter, Spanish epidemiological study...
February 7, 2018: Nefrología: Publicación Oficial de la Sociedad Española Nefrologia
Osamu Ichii, Teppei Nakamura, Takao Irie, Hirokazu Kouguchi, Kozue Sotozaki, Taro Horino, Yuji Sunden, Yaser Hosny Ali Elewa, Yasuhiro Kon
Cotton rat ( Sigmodon hispidus) is a useful experimental rodent for the study of human infectious diseases. We previously clarified that cotton rats, particularly females, developed chronic kidney disease characterized by cystic lesions, inflammation, and fibrosis. The present study investigated female-associated factors for chronic kidney disease development in cotton rats. Notably, female cotton rats developed separation of the pelvic symphysis and hypertrophy in the vaginal parts of the cervix with age, which strongly associated with pyometra...
January 1, 2018: Experimental Biology and Medicine
David Chivite, Francesc Formiga, Xavier Corbella, Alicia Conde-Martel, Óscar Aramburu, Margarita Carrera, Melitón Francisco Dávila, José Pérez-Silvestre, Luis Manzano, Manuel Montero-Pérez-Barquero
BACKGROUND: Dependence for basic activities of the daily living (ADL) relates to adverse outcomes in elderly acute heart failure (AHF) patients. METHODS: We evaluated patients ≥75years admitted because of AHF, divided according to preadmission Barthel Index (BI) category: severe (BI 0-60), moderate (BI 61-90) and slight dependence or independence for basic ADL (BI 91-100). We compared their baseline characteristics and used logistic regression models to determine whether a BI≤60 confers higher one-year mortality risk...
March 1, 2018: International Journal of Cardiology
Adriana Martini, Adriano Ammirati, Carlos Garcia, Carolina Andrade, Odete Portela, Maysa S Cendoroglo, Ricardo Sesso
PURPOSE: The diagnosis of chronic kidney disease (CKD) in elderly individuals has been increasing. The objective of this study was to evaluate physical, mental and social aspects in longevous elderly patients with CKD. METHODS: Eighty patients with CKD (stage 4 and 5, not on dialysis) and 60 longevous elderly (≥ 80 years) paired by gender and age living in the community were evaluated. Physical, cognitive, social and quality of life aspects were analyzed according to the following scales: Charlson comorbidity index, Medical Outcomes Study Short Form 36-Item (SF-36), Medical Outcomes Study, Boston Naming Test, verbal fluency test (animal naming), sit-to-stand test, gait speed, and the Mini-Mental state examination...
February 5, 2018: International Urology and Nephrology
Izabella Uchmanowicz, Anna Chudiak, Beata Jankowska-Polańska, Robbert Gobbens
Hypertension is both a health problem and a financial one globally. It affects nearly 30 % of the general population. Elderly people, aged ≥65 years, are a special group of hypertensive patients. In this group, the overall prevalence of the disease reaches 60 %, rising to 70 % in those aged ≥80 years. In the elderly population, isolated systolic hypertension is quite common. High systolic blood pressure is associated with an increased risk of cardiovascular disease, cerebrovascular disease, peripheral artery disease, cognitive impairment and kidney disease...
November 2017: Cardiac failure review
Kan Sun, Diaozhu Lin, Feng Li, Yiqin Qi, Wanting Feng, Li Yan, Chaogang Chen, Meng Ren, Dan Liu
OBJECTIVES: The effects of lipid metabolism disorder on renal damage have drawn much attention. Using the fatty liver index (FLI) as a validated indicator of hepatic steatosis, this study aims to provide insight about the possible links between fatty liver and the development of chronic kidney disease (CKD). SETTING: Hospital. PARTICIPANTS: We performed a population-based study on 9436 subjects aged 40 years or older. PRIMARY AND SECONDARY OUTCOME MEASURES: FLI is calculated using an algorithm based on body mass index, waist circumference, triglycerides and γ-glutamyltransferase...
January 30, 2018: BMJ Open
Steven G Chrysant
Systolic hypertension, especially isolated systolic hypertension (ISH) is very common in older subjects aged ≥ 65 years and is a major risk factor for cardiovascular disease (CVD), strokes, heart failure (HF) and chronic kidney disease (CKD). It is also, directly and linearly related with these complications irrespective of sex, or ethnicity, but it is worse with the advancement of age. Effective control of systolic blood pressure (SBP), is associated with significant reduction in the incidence of these complications...
February 1, 2018: Postgraduate Medicine
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