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End stage kidney AND elderly

Kyla L Naylor, S Joseph Kim, Eric McArthur, Amit X Garg, Megan K McCallum, Gregory A Knoll
RATIONALE & OBJECTIVE: The mortality rate is high among dialysis patients, but how this compares with other diseases such as cancer is poorly understood. We compared the survival of maintenance dialysis patients with that for patients with common cancers to enhance the understanding of the burden of end-stage kidney disease. STUDY DESIGN: Population-based cohort study. SETTING & PARTICIPANTS: 33,500 incident maintenance dialysis patients in Ontario, Canada, and 532,452 incident patients with cancer (women: breast, colorectal, lung, or pancreas; men: prostate, colorectal, lung, or pancreas) from 1997 to 2015 using administrative health care databases...
January 28, 2019: American Journal of Kidney Diseases: the Official Journal of the National Kidney Foundation
Geraldo Rubens Ramos Freitas, Maria da Luz Fernandes, Fabiana Agena, Omar Jaluul, Sérgio Colenci Silva, Francine Brambate Carvalhinho Lemos, Verônica Coelho, David-Neto Elias, Nelson Zocoler Galante
There is a growing number of elderly kidney transplant (Ktx) recipients. Elderly recipients present lower acute rejection rates but higher incidence of infection and malignancies. Aging per se seems to result in a shift to memory profile and chronic kidney disease (CKD) in premature immunological aging. Understanding aging and CKD effects on the immune system can improve elderly Ktx immunosuppression. We analyzed the effects of aging and CKD in the immune system, comparing healthy adults (HAd) (n=14, 26±2y), healthy elderly (HEld) (n=15, 79±7y), end stage renal disease (ESRD) adults (EnAd) (n=18, 36±7y) and ESRD elderly (EnEld) (n=31, 65±3y) prior to Ktx regarding their naïve, memory and regulatory T and B peripheral lymphocytes...
February 2019: Aging and Disease
Gang Jee Ko, Yoshitsugu Obi, Tae Ik Chang, Melissa Soohoo, Rieko Eriguchi, Soo Jeong Choi, Daniel L Gillen, Csaba P Kovesdy, Elani Streja, Kamyar Kalantar-Zadeh, Connie M Rhee
OBJECTIVES: Among kidney disease patients ≥80 years progressing to end-stage renal disease, there is growing interest in conservative nondialytic management approaches. However, among those who have initiated hemodialysis, little is known about the impact of withdrawal from dialysis on mortality, nor the patient characteristics associated with withdrawal from dialysis. STUDY DESIGN: Historical cohort study. SETTING AND PARTICIPANTS: We examined 133,162 incident hemodialysis patients receiving care within a large national dialysis organization from 2007 to 2011...
January 25, 2019: Journal of the American Medical Directors Association
Cédric Villain, Denis Fouque
No abstract text is available yet for this article.
January 24, 2019: Nephrology, Dialysis, Transplantation
Xiaochun Xiao, Hedong Han, Cheng Wu, Qian He, Yiming Ruan, Yinghong Zhai, Yongqing Gao, Xinxin Zhao, Jia He
BACKGROUND: This study aimed to evaluate the prevalence of atrial fibrillation (AF) in hospital encounters with end-stage chronic obstructive pulmonary disease (COPD) on home oxygen admitted for COPD exacerbation. METHODS: We used the 2003-2014 Nationwide Inpatient Sample to conduct a retrospective analysis. The present study included all patients aged ≥18 years with a primary diagnosis of COPD on home oxygen who were hospitalized for COPD exacerbation. We used multivariate-adjusted models to evaluate the association of AF with clinical factors, cost, length of stay, and hospital outcomes...
January 23, 2019: Chest
Filippo Aucella, Andrea Corsonello, Dario Leosco, Giuliano Brunori, Loreto Gesualdo, Raffaele Antonelli-Incalzi
The dramatic increase in prevalence of chronic kidney disease (CKD) with ageing makes the recognition and correct referral of these patients of paramount relevance in order to implement interventions preventing or delaying the development of CKD complications and end-stage renal disease. Nevertheless, several issues make the diagnosis of CKD in the elderly cumbersome. Among these are age related changes in structures and functions of the kidney, which may be difficult to distinguish from CKD, and multimorbidity...
January 18, 2019: Journal of Nephrology
A Kaul, M R Behera, R Kishore, B Karthikeyan, D S Bhadauria, P Mishra, N Prasad, A Gupta, R K Sharma
Despite kidney transplantation (KT) being considered as the best treatment modality for end-stage renal disease (ESRD), patient and graft survival in the elderly population is poorer than younger individuals. Many authors argue that prolonged life expectancy outweighs the risk of remaining on dialysis, but few studies had compared the treatment modalities, especially with peritoneal dialysis (PD). A retrospective study was conducted at a tertiary care institute to compare outcome of elderly ESRD patients, who received KT with those continued on PD; and to evaluate the predictors of patient survival...
November 2018: Indian Journal of Nephrology
Josefina Maria Sousa Santos Lascasas, Isabel Fonseca, Jorge Malheiro, Sofia Santos, Andreia Campos, Ana Castro, Carla Moreira, Sofia Correia, Idalina Beirão, Luísa Lobato, António Cabrita
INTRODUCTION: Chronic kidney disease (CKD) is an independent risk factor for several unfavorable outcomes including cardiovascular disease (CVD), particularly in the elderly, who represent the most rapidly growing segment of the end-stage kidney disease (ESKD) population. Portugal has the highest European unadjusted incidence and prevalence rates of ESKD. In 2012, we started to follow a cohort of elderly CKD patients, we describe their baseline characteristics, risk profile, and cardiovascular disease burden...
January 10, 2019: Jornal Brasileiro de Nefrologia: ʹorgão Oficial de Sociedades Brasileira e Latino-Americana de Nefrologia
Yu-Hsiang Chou, Chung-Jen Yen, Tai-Shuan Lai, Yung-Ming Chen
BACKGROUND: The incidence of end-stage renal disease (ESRD) is increasing in elderly patients with chronic kidney disease (CKD). This contradicts the general notion that elderly people are more likely to die than to ever reach ESRD. And racial disparity in relation to age on kidney disease outcomes has always been a subject of research interest. AIMS: We investigated the effect of age on outcome in a cohort with stages 3-5 CKD patients by age category. METHODS: A total of 430 patients with a mean age of 65...
January 9, 2019: Aging Clinical and Experimental Research
Andrea K Viecelli, Charmaine E Lok
Choosing the optimal hemodialysis vascular access for the elderly patient is best achieved by a patient-centered coordinated multidisciplinary team approach that aligns the patient's end-stage kidney disease Life-Plan, i.e., the individual treatment approach (supportive care, time-limited or long-term kidney replacement therapy, or combination thereof) and selection of dialysis modality (peritoneal dialysis versus hemodialysis) with the most suitable dialysis access. Finding the right balance between the patient's preferences, the likelihood of access function and survival, and potential complications in the context of available resources and limited patient survival can be extremely challenging...
January 2019: Kidney International
Faheemuddin Azher Ahmed, Angela Georgia Catic
Compared to younger individuals, the prevalence of end-stage renal disease (ESRD) in elders is notably higher. While renal replacement therapy, usually with hemodialysis, is accepted therapy in younger patients with ESRD, decisions regarding the treatment of advanced kidney disease in the elderly population are more complex, secondary to the physiologic changes of aging, concurrent geriatric syndromes, and varying goals of care. Evaluation for possible initiation of dialysis in geriatric patients should be multidisciplinary in nature and patient-focused, including a consideration of physical, cognitive, and social function...
December 20, 2018: Journal of Clinical Medicine
X Y Zhou, Q Zhao, N Wang, R P Wang, Y Zhang, Y T Yu, Y G Jiang, G M Zhao
Objective: To investigate the prevalence and associated factors of chronic kidney diseases (CKD) in adult residents living in a community of Songjiang district, Shanghai. Methods: A total of 9 257 residents aged 20-75 years old in Xinqiao township of Songjiang district were selected by random cluster sampling. All the participants were interviewed to complete a set of personal questionnaire and undergo physical examinations. Urine and blood tests including markers of kidney damage and related associated factors with CKD, were carried out...
December 10, 2018: Zhonghua Liu Xing Bing Xue za Zhi, Zhonghua Liuxingbingxue Zazhi
Seyed-Ali Sadjadi, Surakshya Regmi, Tony Chau
BACKGROUND The elderly population in the United States and the world is rapidly increasing. With aging, immunity and kidney function decrease, thus predisposing people to viral illnesses for which there is no effective prophylaxis. Herpes zoster afflicts the elderly and other immunocompromised patients, like those with end-stage renal disease, transplant recipients, and cancer patients, causing significant morbidity and sometimes mortality. Treating herpes zoster becomes problematic when the regular pharmacokinetics of the antiviral drugs are disturbed...
December 9, 2018: American Journal of Case Reports
Klaudia Nadolnik, Damian Skrypnik, Katarzyna Skrypnik, Pawe Bogdański
Common health problems of the elderly in the near future will become even more common with aging of the population and longer average life expectancy. The elderly tend to have multiple disorders at one time, some of which may aggravate the course of others. One of the most common diseases, diabetes – “the epidemics of XXI century”, treatment of which costs approximately 11% of world health care budget – is the leading reason of chronic kidney disease and end-stage renal disease. Diabetic nephropathy can be a complication of both diabetes mellitus type 1 and 2...
2018: Roczniki Państwowego Zakładu Higieny
Sorino Claudio, Scichilone Nicola, Pedone Claudio, Negri Stefano, Visca Dina, Spanevello Antonio
A significant interaction between kidneys and lungs has been shown in physiological and pathological conditions. The two organs can both be targets of the same systemic disease (eg., some vasculitides). Moreover, loss of normal function of either of them can induce direct and indirect dysregulation of the other one. Subjects suffering from COPD may have systemic inflammation, hypoxemia, endothelial dysfunction, increased sympathetic activation and increased aortic stiffness. As well as the exposure to nicotine, all the foresaid factors can induce a microvascular damage, albuminuria, and a worsening of renal function...
December 6, 2018: Journal of Nephrology
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
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