Read by QxMD icon Read

Elderly dialysis, kidney disease, dementia

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
Alze Pereira Dos Santos Tavares, Carmen Tzanno-Matins, Marcio J C Arruda, Bárbara Antunes
BACKGROUND: Renal Supportive/Palliative Care is gaining gradual recognition as a patient-centered care approach that should be integrated to the traditional disease-centered model of care, mainly in elder patients with advanced chronic kidney disease (CKD). The objective of this study was to assess knowledge, perceptions, attitude, experience and interest in palliative care among renal care providers. METHODS: Online survey, administered between May 23 to June 13, 2017 to members of the Brazilian Society of Nephrology (BSN)...
October 2018: Annals of Palliative Medicine
Eve Miller-Hodges, Neeraj Dhaun
Chronic kidney disease (CKD) is common, its prevalence increasing with age. Cognitive impairment is common in the elderly, in CKD and in those on maintenance haemodialysis. As cognitive impairment is the precursor to dementia, the identification of reversible risk factors for cognitive decline is the key to reducing dementia risk. Arterial stiffness is one such potential risk factor. It is independently associated with cardiovascular outcome in dialysis patients. Importantly, the recent demonstration of an independent association between arterial stiffness and cognitive impairment in these patients suggests that vascular stiffness might be potentially causative in the development of cognitive impairment and also be an opportune target for interventions...
July 1, 2017: Clinical Science (1979-)
Ute Hoffmann
The prevalence of cognitive disorders in CKD-patients is high. A screening of dementia is easy to perform. There are increasing possibilities of cognitive training in dialysis patients.
April 2016: Deutsche Medizinische Wochenschrift
Shina Lee, Jung-Hwa Ryu, Hyunwook Kim, Kyoung Hoon Kim, Hyeong Sik Ahn, Hoo Jae Hann, Yongjae Cho, Young Mi Park, Seung-Jung Kim, Duk-Hee Kang, Kyu Bok Choi, Dong-Ryeol Ryu
BACKGROUND: Although the proportion of the elderly patients with incident end-stage renal disease (ESRD) patients has been increasing in Korea, there has been a lack of information on outcomes of dialysis treatment. This study aimed to assess the survival rate and to elucidate predictors for all-cause mortality among elderly Korean patients initiating dialysis. METHODS: We analyzed 11,301 patients (6,138 men) aged 65 years or older who had initiated dialysis from 2005 to 2008 and had followed up (median, 37...
2014: PloS One
Irene Ying, Zoe Levitt, Sarbjit Vanita Jassal
The burden of cognitive impairment appears to increase with progressive renal disease, such that the prevalence of dementia among those starting dialysis, or those already established on dialysis, is high. The appropriateness of dialysis initiation in this population has been questioned, and current Renal Physician Association guidelines suggest forgoing dialysis in individuals who have dementia and lack awareness of self and environment. Patients are, however, also entitled to equal rights and respect, equal access to health care services, and an opportunity to engage in shared decision-making processes, particularly if there is concern over reversibility of disease...
May 2014: Clinical Journal of the American Society of Nephrology: CJASN
Bernadette Faller, Jean-Baptiste Beuscart, Luc Frimat
BACKGROUND: Reasons underlying dialysis decision-making in Octogenarians and Nonagenarians have not been further explored in prospective studies. METHODS: This regional, multicentre, non-interventional and prospective study was aimed to describe characteristics and quality of life (QoL) of elderly (≥80 years of age) with advanced chronic kidney disease (stage 3b-5 CKD) newly referred to nephrologists. Predictive factors of death and dialysis initiation were also assessed using competing-risk analyses...
May 7, 2013: BMC Nephrology
Kristin Saele, Hogne Sønnesyn, Einar Svarstad, Dag Aarsland
BACKGROUND: Renal failure occurs more frequently among the elderly and elderly patients comprise an increasing proportion of dialysis patients. The objective of this paper is to review the frequency of cognitive impairment among elderly people in dialysis, and discuss causes and consequences of cognitive impairment and dementia in patients with end-stage renal disease. Prevention and treatment of cognitive impairment are discussed. MATERIAL AND METHODS: The review is based on literature retrieved from a search of Medline and other web-sites, review papers and clinical experience...
February 12, 2009: Tidsskrift for Den Norske Lægeforening: Tidsskrift for Praktisk Medicin, Ny Række
X Sarrias Lorenz, E Bardón Otero, M L Vila Paz
Predialysis is a clinical situation in which the patient has significant impairment of kidney function that will ultimately lead to either death or inclusion in kidney replacement therapy (dialysis and/or transplantation). Since a practical and effective dialysis technique was introduced, the length and quality of survival of patients with end-stage renal failure has constantly increased. Contraindications for dialysis are almost never of a renal origin. The obstacles are the concomitant diseases of the patient...
2008: Nefrología: Publicación Oficial de la Sociedad Española Nefrologia
Nada Dimkovic, Dimitrios G Oreopoulos
In the last two decades, most developed countries have seen a continuous growth in the number of elderly patients with end-stage renal disease commencing renal replacement therapy. Despite the many advantages that peritoneal dialysis (PD) offers to elderly patients with ESRD, it is still underutilized in older patients. Older patients are much more vulnerable to the problems associated with aging, which may affect their level of independence and their long-term prognosis. Those patients have physiological changes related to aging and common health problems such as anxiety, depression, dementia, visual impairment, and cognitive impairment, all of which interfere with self-performing PD...
2008: International Urology and Nephrology
M García García, J C Martínez Ocaña, A Rodríguez Jornet, J Almirall, E Ponz, J Ibeas, T López Alba
BACKGROUND: The incidence of chronic renal failure increase with the age. The selection of patient to dialysis has been increasing in spite of the high comorbidity. Moreover, in our clinical practice the aged patient is not contraindicated to dialysis. However, in the nephrology clinical practice not all the patients start the treatment with dialysis. OBJECTIVE The aim of our study has been to compare the characteristics of the patients who had not been dialyzed between the periods 1992-1995 and 2000-2003 to analyze the trend of the nephrology clinical practice...
2007: Nefrología: Publicación Oficial de la Sociedad Española Nefrologia
Manjula Kurella, Donna L Mapes, Friedrich K Port, Glenn M Chertow
BACKGROUND: Recent studies suggest a high prevalence of cognitive impairment and dementia in persons with end-stage renal disease (ESRD), yet risk factors for dementia and its prognostic significance in persons with ESRD remain unclear. The goals of this study were to determine the prevalence, correlates and dialysis-related outcomes of dementia in an international sample of haemodialysis patients. METHODS: We analysed data collected from a cohort of 16 694 patients in the Dialysis Outcomes and Practice Patterns Study...
September 2006: Nephrology, Dialysis, Transplantation
Hiroshi Kitamura, Masamitsu Fujii
No abstract text is available yet for this article.
June 2004: Nihon Rinsho. Japanese Journal of Clinical Medicine
Shirley Drayton, Amy Canter, Cynthia Allen
The provision of patient-focused care to the elderly is often fraught with many ethical and challenging dilemmas. However, for health care professionals, these dilemmas can be magnified when the chronic disease is accompanied by dementia. Such was the case of Mrs. A. The multidisciplinary team of a 36-bed acute care unit identified the challenges they experienced while caring for a 65-year-old female with multiple medical problems: diabetes; hypertension; cardiovascular disease; end stage renal disease and dementia probably due to cardiovascular and metabolic causes...
October 2003: CANNT Journal, Journal ACITN
Lewis M Cohen, Michael J Germain, David M Poppel
Cessation of life-support treatment is an appropriate option for situations in which the burdens of therapy substantially outweigh the benefits. Decisions to withdraw dialysis now precede 1 in 4 deaths of patients who have end-stage renal disease. Guidelines have been recently published to assist clinicians in making these complex and emotionally charged determinations, and they include: relying on shared decision making by all participants, obtaining informed consent, estimating the prognosis on dialysis, adopting a systematic approach for conflict resolution of disagreements, honoring advance directives, and ensuring the provision of palliative care...
April 23, 2003: JAMA: the Journal of the American Medical Association
N B Roberts, A Clough, J P Bellia, J Y Kim
Serum aluminium was significantly raised (p < 0.01) up to 2-3-fold, in patients with dementia including Alzheimers Disease (AD) 0.66 +/- 0.2 (mumol/l mean +/- 1 s.d.) and patients on regular aluminium hydroxide therapy 0.54 +/- 0.17, compared with healthy volunteers 0.21 +/- 0.13, although not as high as in patients with end stage renal failure on regular dialysis 0.88 +/- 0.42. The urine outputs (mumol/l mean +/- 1 s.d.) of aluminium and silicon, respectively, were also significantly increased up to 5-fold in dementia 2...
February 15, 1998: Journal of Inorganic Biochemistry
F Mignon, C Michel, F Mentre, B Viron
Aging will be a serious social problem in the future. The number of patients of 75 years and over with end-stage renal disease (ESRD) is bound to increase. The time has come to pay greater attention to their problems before and during dialysis treatment. Prevention of ESRD is an important challenge, especially in the field of vascular diseases which are the main cause of ESRD in the elderly. The exact number of elderly patients who will require dialysis in the next few years is difficult to foresee. It is only when the incidence of patients starting dialysis at 75 and over levels off that we may assume that elderly patients are no longer rejected from treatment; we could then assess the actual need in dialysis facilities...
June 1993: Kidney International. Supplement
A M Schrander-v d Meer, J L van Saase, A P Roodvoets, W T van Dorp
We studied all patients receiving renal replacement therapy (RRT) in the Kennemer Gasthuis Dialysis Centre (Haarlem) during the period January 1st 1986 to January 1st 1991 in order to evaluate their mortality. Of the total number 205 patients, 76 had died in this period, 82 were still receiving RRT on December 31st 1991 and 47 had been transplanted. The most frequent cause of death was cardiovascular. Of the 76 patients who had died, 38 had requested cessation of dialysis. Of these, 26% had also a malignancy and 29% had irreversible brain damage (CVA, dementia)...
March 1995: Clinical Nephrology
Fetch more papers »
Fetching more papers... Fetching...
Read by QxMD. Sign in or create an account to discover new knowledge that matter to you.
Remove bar
Read by QxMD icon Read

Search Tips

Use Boolean operators: AND/OR

diabetic AND foot
diabetes OR diabetic

Exclude a word using the 'minus' sign

Virchow -triad

Use Parentheses

water AND (cup OR glass)

Add an asterisk (*) at end of a word to include word stems

Neuro* will search for Neurology, Neuroscientist, Neurological, and so on

Use quotes to search for an exact phrase

"primary prevention of cancer"
(heart or cardiac or cardio*) AND arrest -"American Heart Association"