scholarly journals Influence Of Mild Pulmonary Congestion On Diaphragmatic Mobility And Activities Of Daily Living In Chronic Kidney Disease: An Experimental And Clinical Study

Nefrología ◽  
2021 ◽  
Author(s):  
Davi de Souza Francisco ◽  
Catherine Corrêa Peruzzolo ◽  
Débora Petry Moecke ◽  
Wellington Pereira Yamaguti ◽  
Deborah Hizume Kunzler ◽  
...  
Keyword(s):  
Chronic Kidney Disease ◽  
Clinical Study ◽  
Kidney Disease ◽  
Activities Of Daily Living ◽  
Daily Living ◽  
Pulmonary Congestion

Pretransplant Comprehensive Geriatric Assessment in Older Patients with Advanced Chronic Kidney Disease

Nephron ◽  
2021 ◽  
pp. 1-10
Author(s):  
Teddy Novais ◽  
Elodie Pongan ◽  
Frederic Gervais ◽  
Marie-Hélène Coste ◽  
Emmanuel Morelon ◽  
...  
Keyword(s):  
Chronic Kidney Disease ◽  
Decision Making ◽  
Kidney Disease ◽  
Activities Of Daily Living ◽  
Physical Function ◽  
Comprehensive Geriatric Assessment ◽  
Daily Living ◽  
Older Patients ◽  
Advanced Chronic Kidney Disease ◽  
Comorbidity Burden

<b><i>Background:</i></b> In older patients with advanced chronic kidney disease (CKD), the decision of kidney transplantation (KT) is a challenge for nephrologists. The use of comprehensive geriatric assessment (CGA) is increasingly gaining interest into the process of decision-making about treatment modality choice for CKD. The aim of this study was to assess the prevalence of geriatric impairment and frailty in older dialysis and nondialysis patients with advanced CKD using a pretransplant CGA model and to identify geriatric impairments influencing the geriatricians’ recommendations for KT. <b><i>Methods:</i></b> An observational study was conducted with retrospective data from July 2017 to January 2020. Patients aged ≥65 years with advanced CKD, treated or not with dialysis, and referred by the nephrologist were included in the study. The CGA assessed comorbidity burden, cognition, mood, nutritional status, (instrumental) activities of daily living, physical function, frailty, and polypharmacy. Geriatric impairments influencing the geriatricians’ recommendations for KT were identified using univariate and multivariate logistic regressions. <b><i>Results:</i></b> 156 patients were included (74.2 ± 3.5 years and 62.2% on dialysis). Geriatric conditions were highly prevalent in both dialysis and nondialysis groups. The rate of geriatric impairments was higher in dialysis patients regarding comorbidity burden, symptoms of depression, physical function, autonomy, and frailty. Geriatrician’s recommendations for KT were as follows: favorable (79.5%) versus not favorable or multidisciplinary discussion needed with nephrologists (20.5%). Dependence for Instrumental Activities of Daily Living (IADL) (odds ratio [OR] = 3.01 and 95% confidence interval [CI] = 1.30–7.31), physical functions (OR = 2.91 and 95% CI = 1.08–7.87), and frailty (OR = 2.66 and 95% CI = 1.07–6.65) were found to be independent geriatric impairments influencing geriatrician’s recommendations for KT. <b><i>Conclusions:</i></b> Understanding the burden of geriatric impairment provides an opportunity to direct KT decision-making and to guide interventions to prevent functional decline and preserve quality of life.

scholarly journals Limitations in Activities of Daily Living in Individuals With Chronic Kidney Disease: Biopsychosocial Factors of the Brazilian Population

2021 ◽  
Author(s):  
Hellen Carvalho Lima ◽  
Carla Daniele Ferreira Dantas ◽  
Adson Aragão Araújo Santos ◽  
Adirlene Pontes Oliveira Tenório ◽  
Marcello Barbosa Otoni Gonçalves Guedes ◽  
...  
Keyword(s):  
Chronic Kidney Disease ◽  
Kidney Disease ◽  
Activities Of Daily Living ◽  
Daily Living ◽  
Cox Regression ◽  
Prevalence Ratio ◽  
National Health Survey ◽  
Brazilian Population ◽  
Significance Level ◽  
The Relationship

Abstract This study assesses the relationship between biopsychosocial factors and limitations in activities of daily living (ADL) in individuals with chronic kidney disease (CKD). Individual data from the National Health Survey were analyzed, with a sample size of 839 participants. The outcome was dichotomous, presenting limitations in ADL, and the factors considered were clinical and health characteristics, self-perceived behavior, contextual social support, and housing. Cox regression was applied to control the interaction between factors, using the prevalence ratio as a measure of effect and a significance level of 5%. A total of 839 individuals with CKD were reported, of which 373 (40.7%: 35.4 - 46.1%) reported having limitations in ADL. The presence of limitations in ADL was related to residing in a rural area, as well as to the absence of private health insurance, worse self-perceived health, presence of depressive symptoms, and disabilities, in addition to the use of medications and hemodialysis. Limitations in ADL in individuals with CKD are associated with biopsychosocial factors in the Brazilian population, requiring public policies that enable better therapeutic management and support for behavioral health and contextual needs.

scholarly journals Evaluation of risk factors that contribute to falls among the elderly

2017 ◽  
Vol 20 (1) ◽  
pp. 56-66 ◽  
Author(s):  
Raquel Letícia Tavares Alves ◽  
Carlos Fernando Moreira e Silva ◽  
Luísa Negri Pimentel ◽  
Isabela de Azevedo Costa ◽  
Ana Cristina dos Santos Souza ◽  
...  
Keyword(s):  
Risk Factors ◽  
Chronic Kidney Disease ◽  
Kidney Disease ◽  
Activities Of Daily Living ◽  
Daily Living ◽  
The Elderly ◽  
Minas Gerais ◽  
The State ◽  
Elderly Persons ◽  
The City

Abstract Objective: to determine the incidence of falls among the elderly population of the city of Barbacena in the state of Minas Gerais, together with causal factors, circumstances and major consequences. Methods: a cross-sectional study was performed through questionnaires applied to 206 patients over the age of 60, from November 2014 to February 2015 in the city of Barbacena, in the state of Minas Gerais. Risk factors related to falls were analyzed, as well as the incidence of falls and the consequences for the lives of elderly persons. The existence of a relationship between the reporting of falls and possible risk factors was determined by the Chi-squared and Fischer's exact tests as indicated. Results: an incidence of falls of 36.41% was observed among the elderly, 45.95% of which occurred outside the home. A total of 85.71% of respondents had previously suffered strokes and 39.78% were taking medication. Among elderly persons who have fallen and suffered fractures (18.67%), 50% had suffered strokes, 50% were suffering from chronic kidney disease, and 61.54% could not perform their activities of daily living after the fall. Conclusion: it was concluded that the incidence of falls among the elderly was 36.41%, while the most correlated factors were drug use, stroke victims and people with chronic kidney disease. Among those who suffered fractures, 61.54% failed to perform activities of daily living. Preventing falls is a public health concern, and simple changes can reduce its prevalence.

scholarly journals FUNCTIONAL INDEPENDENCE, ACCESS TO KIDNEY TRANSPLANTATION, AND WAITLIST MORTALITY

2019 ◽  
Vol 3 (Supplement_1) ◽  
pp. S494-S495
Author(s):  
Nadia M Chu ◽  
Stephanie Sison ◽  
Abimereki Muzaale ◽  
Christine Haugen ◽  
Jacqueline Garonzik Wang ◽  
...  
Keyword(s):  
Kidney Transplantation ◽  
Kidney Disease ◽  
Activities Of Daily Living ◽  
Competing Risks ◽  
Mortality Risk ◽  
Daily Living ◽  
Functional Independence ◽  
End Stage Kidney Disease ◽  
End Stage ◽  
Waitlist Mortality

Abstract Although functional independence is a health priority for patients with advanced CKD, 50% of those who progress to end-stage kidney disease (ESKD) develop difficulties carrying-out essential day-to-day activities. Functional independence is not routinely assessed at kidney transplant (KT) evaluation; therefore, it is unclear what percentage of candidates are functionally independent and whether independence is associated with access to KT and waitlist mortality. We studied a prospective cohort of 3,168 ESKD participants (1/2009-6/2018) who self-reported functional independence in basic Activities of Daily Living (ADL) and more complex Instrumental Activities of Daily Living (IADL). We estimated adjusted associations between functional independence (separately) and listing (Cox), waitlist mortality (competing risks), and transplant rates (Poisson). At evaluation, 92.4% were independent in ADLs, but only 68.5% were independent in IADLs. Functionally independent participants had a higher chance of listing for KT (ADL:aHR=1.55,95%CI:1.30-1.87; IADL:aHR=1.39,95%CI 1.26-1.52). Among KT candidates, ADL independence was associated with lower waitlist mortality risk (SHR=0.66,95%CI:0.44-0.98) and higher rate of KT (IRR=1.58,95%CI:1.12-2.22); the same was not observed for IADL independence (SHR=0.86,95%CI:0.65-1.12; IRR=1.01,95%CI:0.97-1.19). ADL independence was associated with better KT access and lower waitlist mortality; clinicians should screen KT candidates for ADL independence, and identify interventions to maintain independence to improve waitlist outcomes.

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