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Geriatric and chronic kidney disease

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
Umesh Kapil, Ritika Khandelwal, Lakshmy Ramakrishnan, Preetika Khenduja, Aakriti Gupta, Ravindra Mohan Pandey, Ashish Datt Upadhyay, Ravi Shankar Belwal
Background: Hypertension (HTN) and diabetes mellitus (DM) both are rapidly emerging as public health problems among geriatric population in developing countries. HTN can lead to stroke, myocardial infarction, congestive heart failure, and chronic kidney diseases among geriatric population. DM increases the risk of coronary heart disease, cerebrovascular disease, peripheral vascular disease, retinopathy, nephropathy, and neuropathy among geriatric population. Methodology: A community-based, cross-sectional study was conducted during 2015-2016 in District Nainital, Uttarakhand...
November 2018: Journal of Family Medicine and Primary Care
Joseph T Hanlon, Subashan Perera, Paul J Drinka, Christopher J Crnich, Steven J Schweon, Michele Klein-Fedyshin, Charles B Wessel, Stacey Saracco, Gulsum Anderson, Mary Mulligan, David A Nace
OBJECTIVE: To establish consensus recommendations for empirical treatment of uncomplicated cystitis with anti-infectives in noncatheterized older nursing home residents to be implemented in the Improving Outcomes of UTI Management in Long-Term Care Project (IOU) funded by the Agency for Healthcare Research and Quality. DESIGN: Two-round modified Delphi survey. PARTICIPANTS: Expert panel of 19 clinical pharmacists. MEASUREMENTS: Comprehensive literature search and development/review/edit of draft survey by the investigative group (one geriatric clinical pharmacist, two geriatric medicine physicians, and one infectious disease physician)...
December 24, 2018: Journal of the American Geriatrics Society
Chia-Ter Chao, Yi-Hsuan Lee, Kuen-Cheh Yang, Jen-Kuei Peng, Chia-Ming Li, Shih-I Chen, Der-Sheng Han, Jenq-Wen Huang, Cogent Study Group
BACKGROUND/AIMS: Awareness of chronic kidney disease (CKD) has been low among affected patients, particularly the older ones. However, whether such awareness is synonymous with the presence of laboratory-diagnosed CKD among older adults is currently unclear. METHODS: We enrolled community-dwelling old adults (≥ 65 years) who received health examinations between 2013 and 2016 from a regional metropolitan hospital. Clinical information and geriatric syndromes including depression, cognitive impairment, fall, quality of life, and visual disturbance were evaluated during the medical interview...
2018: Kidney & Blood Pressure Research
Francesc Formiga, Rafael Moreno-Gonzalez, David Chivite, Sergi Yun, Jonathan Franco, Albert Ariza-Solé, Xavier Corbella
AIM: To assess whether 1-year mortality in older patients experiencing a first admission for acute heart failure was related to sex, and to explore differential characteristics according to sex. METHODS: We reviewed the medical records of 1132 patients aged >70 years of age admitted within a 3-year period because of a first episode of acute heart failure. We analyzed sex differences. Mortality was assessed using multivariate Cox analysis. RESULTS: There were 648 (57...
December 12, 2018: Geriatrics & Gerontology International
Sophie Samso, Marc-Arthur Loko, Amélie Jamet, Françoise Bouthier-Quintard, Marc Paccalin, Evelyne Liuu
Over three million French people present a severe chronic kidney disease, among which there is a high prevalence of elder subjects. We conducted a prospective monocentric study in a geriatric acute care ward. The aims were to determine the short-term prognosis of patients with severe chronic kidney disease and to determine the factors associated with mortality at six-months. METHODS: Patients 75 years of age and older, with an estimated glomerular filtration rate (eGFR) < 30 mL/min/1...
December 1, 2018: Gériatrie et Psychologie Neuropsychiatrie du Vieillissement
Manuel Heras Benito, María José Fernández-Reyes Luis
Chronic kidney disease is common in people >65years of age. The development and improvement of dialysis techniques has allowed its generalisation to the entire population, when there is a situation of terminal nephropathy, without limit of use due to chronological age. Decision making in elderly patients with advanced chronic kidney disease is complex: in addition to renal parameters, both comorbidity and the presence of geriatric syndromes must be considered. This review addresses the management of information, the decision making of different treatment modalities that can be offered to these patients, and the time of initiation and/or withdrawal of dialysis...
October 17, 2018: Medicina Clínica
Namiko A Goto, Marije E Hamaker, Hanna C Willems, Marianne C Verhaar, Mariëlle H Emmelot-Vonk
PURPOSE: The aim of the current study was to evaluate the association between a decreased estimated glomerular filtration rate (eGFR) and accidental falling in elderly patients who visited the day clinic of the department of geriatric medicine of the University of Medical Center Utrecht (UMCU). STUDY DESIGN: A cross-sectional analysis with people aged ≥ 65 years of the Utrecht Cardiovascular Cohort was performed. Patients were stratified into different stages of kidney disease (< 45, 45-59, and ≥ 60 ml/min per 1...
October 15, 2018: International Urology and Nephrology
Andrea Corsonello, Lisanne Tap, Regina Roller-Wirnsberger, Gerhard Wirnsberger, Carmine Zoccali, Tomasz Kostka, Agnieszka Guligowska, Francesco Mattace-Raso, Pedro Gil, Lara Guardado Fuentes, Itshak Meltzer, Ilan Yehoshua, Francesc Formiga-Perez, Rafael Moreno-González, Christian Weingart, Ellen Freiberger, Johan Ärnlöv, Axel C Carlsson, Silvia Bustacchini, Fabrizia Lattanzio
BACKGROUND: Decline of renal function is common in older persons and the prevalence of chronic kidney disease (CKD) is rising with ageing. CKD affects different outcomes relevant to older persons, additionally to morbidity and mortality which makes CKD a relevant health burden in this population. Still, accurate laboratory measurement of kidney function is under debate, since current creatinine-based equations have a certain degree of inaccuracy when used in the older population. The aims of the study are as follows: to assess kidney function in a cohort of 75+ older persons using existing methodologies for CKD screening; to investigate existing and innovative biomarkers of CKD in this cohort, and to align laboratory and biomarker results with medical and functional data obtained from this cohort...
October 11, 2018: BMC Nephrology
Laura K Triantafylidis, Chelsea E Hawley, Laura P Perry, Julie M Paik
Older adults with chronic kidney disease (CKD) often experience polypharmacy, a recognized predictor of prescribing problems including inappropriately dosed medications, drug-drug and drug-disease interactions, morbidity and mortality. Polypharmacy is also associated with nonadherence, which leads to recurrent hospitalizations and poorer hemodialysis outcomes in CKD patients. Further complicating medication management in this vulnerable population are the physiologic changes that occur with both age and CKD...
November 2018: Drugs & Aging
Byoung-Geun Han, Jun Young Lee, Jae-Seok Kim, Jae-Won Yang
BACKGROUND: Fluid overload and protein-energy wasting (PEW) are common in patients with end-stage renal disease (ESRD) and lead to a poor prognosis. We aimed to evaluate the volume and nutritional status of ESRD patients and to determine the clinical significance of phase angle (PhA). METHODS: This study was a cross-sectional comparison of bioimpedance spectroscopy (BIS) findings in patients with non-dialysis chronic kidney disease (CKD) stage 5 (CKD5-ND, N = 80) and age/sex-matched peritoneal dialysis patients (PD, N = 80)...
September 19, 2018: Nutrients
Michaela Katja Stangl, Wolfgang Böcker, Vladimir Chubanov, Uta Ferrari, Michael Fischereder, Thomas Gudermann, Eric Hesse, Peter Meinke, Martin Reincke, Nicole Reisch, Maximilian M Saller, Jochen Seissler, Ralf Schmidmaier, Benedikt Schoser, Cornelia Then, Barbara Thorand, Michael Drey
Sarcopenia in geriatric patients is often associated with or even caused by changes of the endocrine and nervous system. The multifactorial pathogenesis of sarcopenia and additional multimorbidity in geriatric patients makes it difficult to study distinct pathogenic pathways leading to sarcopenia. Patients suffering from diabetes, Cushing's syndrome, chronic kidney disease, Klinefelter's syndrome or motor neuron diseases, such as amyotrophic lateral sclerosis for example are known to have impaired muscle property and reduced physical performance...
September 10, 2018: Experimental and Clinical Endocrinology & Diabetes
Jack S Lawson, Hui-Hsuan Liu, Harriet M Syme, Robert Purcell, Caroline P D Wheeler-Jones, Jonathan Elliott
Chronic kidney disease (CKD) is common in both geriatric cats and aging humans, and is pathologically characterised by chronic tubulointerstitial inflammation and fibrosis in both species. Cats with CKD may represent a spontaneously occurring, non-rodent animal model of human disease, however little is known of feline renal cell biology. In other species, TGF-β1 signalling in the proximal tubular epithelium is thought to play a key role in the initiation and progression of renal fibrosis. In this study, we first aimed to isolate and characterise feline proximal tubular epithelial cells (FPTEC), comparing them to human primary renal epithelial cells (HREC) and the human proximal tubular cell line HK-2...
2018: PloS One
Faheemuddin Azher Ahmed
The population in the United States is aging and presents many challenges in the healthcare world. According to the report released by United States Census Bureau in June 2017, there are around 50 million residents aged 65 years and over as of 2016. Among the multiple healthcare challenges, kidney disease is a significant one because of its high burden, high cost and low awareness. Medicare spending on chronic kidney disease for 65 plus aged patients exceeded $ 50 billion in 2013. Different studies based on different calculations have estimated that at least one-third of chronic kidney disease patients are aged above 65 years...
August 2018: Aging and Disease
Jun Young Lee, Jae-Seok Kim, Jae-Won Yang, Seung Ok Choi, Joon Hyung Sohn, Byoung-Geun Han
OBJECTIVE: Malnutrition is very complex in patients with end-stage renal disease (ESRD) and is associated with poor prognosis. This is because hemodynamic changes, hormonal changes, persistent inflammatory reactions, and fluid overloads are more complicated as uremia is worsening. Bio-impedance spectroscopy (BIS) is a useful method to estimate fluid balance (Overhydration/ extracellular water, OH/ECW) and nutritional status (Phase angle, PhA). We aimed to evaluate the volume and nutritional status by BIS and to investigate the relationship between the appetite regulating hormones and the parameters of BIS in patients with stage 5 chronic kidney disease not undergoing dialysis (CKD5-ND)...
2018: PloS One
Qinglin Li, Meng Zhao, Xiaodan Wang
Objectives: To compare the differences between the Kidney Disease Improving Global Outcomes (KDIGO) criteria of the 48-hour window and the 7-day window in the diagnosis of acute kidney injury (AKI) in very elderly patients, as well as the relationship between the 48-hour and 7-day windows for diagnosis and 90-day mortality. Patients and methods: We retrospectively enrolled very elderly patients (≥75 years old) from the geriatrics department of the Chinese PLA General Hospital between January 2007 and December 2015...
2018: Clinical Interventions in Aging
Silvia Lai, Alessio Molfino, Oriano Mecarelli, Patrizia Pulitano, Santo Morabito, Valentina Pistolesi, Roberto Romanello, Alessia Zarabla, Alessandro Galani, Nicla Frassetti, Paola Aceto, Carlo Lai
Neurological, psychological, and cognitive disorders in chronic kidney disease may contribute to poor quality of life in these patients. The aim of this study was to assess the electroencephalographic, psychological, and cognitive changes before and after hemodialysis (HD) compared with healthy controls (HC). Sixteen HD patients and 15 HC were enrolled. Electroencephalogram (EEG), Minnesota multiphasic personality inventory (MMPI-2) Satisfaction profile (SAT-P), and Neuropsychological test Global z-scores (NPZ5) were performed before (T0) and after (T1) HD treatment and in HC...
October 2018: Therapeutic Apheresis and Dialysis
Tamas Csipo, Gabor A Fulop, Agnes Lipecz, Stefano Tarantini, Tamas Kiss, Priya Balasubramanian, Anna Csiszar, Zoltan Ungvari, Andriy Yabluchanskiy
Obesity is one of the major risk factors for cardiovascular diseases and its prevalence is increasing in all age groups, with the biggest impact observed in middle-aged and older adults. A critical mechanism by which obesity promotes vascular pathologies in these patients involves impairment of endothelial function. While endothelial dysfunction in large vessels promotes atherogenesis, obesity-induced microvascular endothelial dysfunction impairs organ perfusion and thereby is causally related to the pathogenesis of ischemic heart disease, chronic kidney disease, intermittent claudication, exercise intolerance, and exacerbates cognitive decline in aging...
June 18, 2018: GeroScience
Giuseppe Coppolino, Davide Bolignano, Pietro Gareri, Carmen Ruberto, Michele Andreucci, Giovanni Ruotolo, Maurizio Rocca, Alberto Castagna
BACKGROUND AND AIMS: Cognitive and renal impairment are pervasive among elderly frails, a high-risk, geriatric sub-population with peculiar clinical characteristics. In a series of frail individuals with non-advanced chronic kidney disease (CKD), we aimed at assessing the entity of functional, general health and cognitive impairment and the possible relationship between these types of dysfunction and the severity of renal impairment. METHODS: 2229 geriatric subjects were screened for frailty and CKD...
August 2018: International Urology and Nephrology
John M Brooks, Cole G Chapman, Manish Suneja, Mary C Schroeder, Michelle A Fravel, Kathleen M Schneider, June Wilwert, Yi-Jhen Li, Elizabeth A Chrischilles, Douglas W Brenton, Marian Brenton, Jennifer Robinson
BACKGROUND: Our objective is to estimate the effects associated with higher rates of renin-angiotensin system antagonists, angiotensin-converting enzyme inhibitors and angiotensin receptor blockers (ACEI/ARBs), in secondary prevention for geriatric (aged >65 years) patients with new ischemic strokes by chronic kidney disease (CKD) status. METHODS AND RESULTS: The effects of ACEI/ARBs on survival and renal risk were estimated by CKD status using an instrumental variable (IV) estimator...
May 30, 2018: Journal of the American Heart Association
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