End-Stage Kidney Disease in the Elderly: Approach to Dialysis Initiation, Choosing Modality, and Predicting Outcomes

2016 ◽  
Vol 23 (1) ◽  
pp. 36-43 ◽  
Author(s):  
Joseph R. Berger ◽  
Vishal Jaikaransingh ◽  
S. Susan Hedayati
Keyword(s):  
Kidney Disease ◽  
The Elderly ◽  
Dialysis Initiation ◽  
End Stage Kidney Disease ◽  
End Stage

scholarly journals Causes and risk factors for acute dialysis initiation among patients with end-stage kidney disease—a large retrospective observational cohort study

2018 ◽  
Vol 12 (4) ◽  
pp. 550-558 ◽  
Author(s):  
Nish Arulkumaran ◽  
Arunraj Navaratnarajah ◽  
Camilla Pillay ◽  
Wendy Brown ◽  
Neill Duncan ◽  
...  
Keyword(s):  
Risk Factors ◽  
Cardiovascular Disease ◽  
Kidney Disease ◽  
Primary Objective ◽  
Dialysis Initiation ◽  
End Stage Kidney Disease ◽  
Acute Dialysis ◽  
Independent Risk Factors ◽  
The Difference ◽  
End Stage

AbstractBackgroundPatients who require acute initiation of dialysis have higher mortality rates when compared with patients with planned starts. Our primary objective was to explore the reasons and risk factors for acute initiation of renal replacement therapy (RRT) among patients with end-stage kidney disease (ESKD). Our secondary objective was to determine the difference in glomerular filtration rate (GFR) change in the year preceding RRT between elective and acute dialysis starts.MethodsWe conducted a single-centre retrospective observational study. ESKD patients either started dialysis electively (planned starters) or acutely and were known to renal services for >90 (unplanned starters) or <90 days (urgent starters).ResultsIn all, 825 consecutive patients initiated dialysis between January 2013 and December 2015. Of these, 410 (49.7%) patients had a planned start. A total of 415 (50.3%) patients had an acute start on dialysis: 244 (58.8%) unplanned and 171 (41.2%) urgent. The reasons for acute dialysis initiation included acute illness (58%) and unexplained decline to ESKD (33%). Cardiovascular disease [n = 30 (22%)] and sepsis [n = 65 (48%)] accounted for the majority of acute systemic illness. Age and premorbid cardiovascular disease were independent risk factors for acute systemic illness among unplanned starts, whereas autoimmune disease accounted for the majority of urgent starts. The rate of decline in GFR was greater in the month preceding RRT among acute dialysis starters compared with planned starters (P < 0.001).ConclusionsCardiovascular disease and advancing age were independent risk factors for emergency dialysis initiation among patients known to renal services for >3 months. The rapid and often unpredictable loss of renal function in the context of acute systemic illness poses a challenge to averting emergency dialysis start.

scholarly journals A massive natural disaster, the Great East Japan Earthquake, and the incidence of dialysis due to end-stage kidney disease

2021 ◽  
Author(s):  
Michiaki Abe ◽  
Tetsuya Akaishi ◽  
Koto Ishizawa ◽  
Hirohisa Shinano ◽  
Hiroshi Ohtomo ◽  
...  
Keyword(s):  
Diabetic Nephropathy ◽  
Kidney Disease ◽  
Renal Disease ◽  
Great East Japan Earthquake ◽  
Dialysis Initiation ◽  
Renal Diseases ◽  
City Hospital ◽  
End Stage Kidney Disease ◽  
Significant Difference ◽  
End Stage

Abstract Background Disaster-related stress can increase blood pressure and the incidence of cardiovascular diseases. However, the role of massive disasters in the development of end-stage kidney disease (ESKD) remains unknown. We investigated the incidence and different causes of dialysis initiation in patients with chronic kidney disease in a city affected by the Great East Japan Earthquake. Methods This was a single-center, retrospective observational study. All patients who initiated or were treated with dialysis at Kesennuma City Hospital between 2007 and 2020 were enrolled. The year of dialysis initiation was retrospectively determined based on the initiation date. The causative renal diseases that led to the need for dialysis initiation were divided into four groups: diabetic nephropathy, hypertensive renal disease, glomerulonephritis, and others. Results Age at dialysis initiation differed significantly among the four groups (p = 0.0262). There was a significant difference in the numbers of the four groups before and after the Great East Japan Earthquake (p = 0.0193). The age of hypertensive renal disease patients was significantly higher than those of patients with diabetic nephropathy (p = 0.0070) and glomerulonephritis (p = 0.0386) after the disaster. The increasing number of dialysis initiations after the Great East Japan Earthquake appeared to be associated with changes in hypertensive renal diseases; the number peaked after 10 years. Conclusions There was an increase in the number of dialysis initiations, especially caused by hypertensive renal diseases, for up to 10 years after the Great East Japan Earthquake. Graphic abstract

scholarly journals End stage kidney disease in the elderly: Hope for the best

2021 ◽  
Vol 34 (4) ◽  
Author(s):  
Patrícia Valério ◽  
◽  
Ana Farinha ◽  
Keyword(s):  
Kidney Disease ◽  
The Elderly ◽  
End Stage Kidney Disease ◽  
Disease Trajectory ◽  
Technological Advances ◽  
Care Of Elderly ◽  
End Stage ◽  
Symptomatic Control ◽  
Taking Care

With an increased number of aged chronic kidney disease (CKD) patients, along with medical and technological advances, the options to approach end‑stage kidney disease (ESKD) have multiplied. Nephrologists should be aware that taking care of elderly patients is different from taking care of younger ones. The spectrum of choices is as wide as the functional status of these patients. For fit ones, the main goal should be to restore function as much as possible and to rehabilitate. On the other hand, for frail patients, the expectations should be realistic in terms of survival, disease trajectory and symptomatic control, because while kidney replacement therapies can prolong life, they do not cure. The issue is complex due to its multidimensional perspective, so decisions must take into account the patient’s options, respecting his/her autonomy, dignity and quality of life. This text aims to review the particularities of geriatric CKD patients’ assessment towards options to care for ESKD, in a specific population which is growing in our practice.

scholarly journals Implication of Trends in Timing of Dialysis Initiation for Incidence of End-stage Kidney Disease

2020 ◽  
Vol 180 (12) ◽  
pp. 1647
Author(s):  
Chi-yuan Hsu ◽  
Rishi V. Parikh ◽  
Leonid N. Pravoverov ◽  
Sijie Zheng ◽  
David V. Glidden ◽  
...  
Keyword(s):  
Kidney Disease ◽  
Dialysis Initiation ◽  
End Stage Kidney Disease ◽  
End Stage

Plasma visfatin/nicotinamide phosphoribosyltransferase (visfatin/NAMPT) concentration is not related to kidney function in elderly subjects

2015 ◽  
Vol 53 (5) ◽  
Author(s):  
Piotr Kocelak ◽  
Magdalena Olszanecka-Glinianowicz ◽  
Aleksander Owczarek ◽  
Maria Bozentowicz-Wikarek ◽  
Aniceta Brzozowska ◽  
...  
Keyword(s):  
Kidney Disease ◽  
Elderly Population ◽  
The Elderly ◽  
Elderly Subjects ◽  
Elisa Method ◽  
End Stage Kidney Disease ◽  
Estimated Gfr ◽  
Nicotinamide Phosphoribosyltransferase ◽  
Excretory Function ◽  
End Stage

AbstractStudies assessing plasma visfatin/nicotinamide phosphoribosyltransferase (NAMPT) concentrations in chronic kidney disease with the ELISA method are restricted mainly to subjects with end-stage kidney disease. Therefore, little is known about to what extent glomerular filtration rate (GFR) affects the plasma levels of visfatin/NAMPT. The aim of this study was to assess the relations between circulating visfatin/NAMPT levels and estimated GFR (eGFR), independently of potential confounders such as inflammation, nutritional status, and insulin resistance in the elderly population.The analysis included 3023 elderly subjects (1076 with impaired kidney excretory function – eGFR <60 mL/min/1.73 mSimilar plasma visfatin/NAMPT levels were found in subjects with eGFR ≥60 and <60 mL/min/1.73 mThe results of our study suggest that plasma visfatin/NAMPT levels are not affected by impaired kidney excretory function in elderly subjects.

scholarly journals Has Covid-19 reduced the management of end-stage kidney disease in 2020?

2021 ◽  
Vol 4 (1) ◽  
pp. 53-54
Author(s):  
Jacobs Lucas Pierre-michel ◽  
Frederic Collart ◽  
Thomas Baudoux ◽  
Catherine Bonvoisin ◽  
Jean-Marc De Smet ◽  
...  
Keyword(s):  
Kidney Disease ◽  
Renal Disease ◽  
End Stage Renal Disease ◽  
Dialysis Initiation ◽  
Ambulatory Patient ◽  
End Stage Kidney Disease ◽  
Marked Decline ◽  
Stage Renal Disease ◽  
End Stage

The SARS-CoV-2 pandemic has been associated with a drop in diagnoses of several diseases in 2020, including cancers. In this letter addressed to the editor, the Groupement des Néphrologues Francophones de Belgique (GNFB), assessed whether there was a similar effect concerning end-stage renal disease (ESRD). Data of patients with ESRD form 25 of the 26 centers constituting the GNFB register were collected. In conclusion, the year 2020 was marked by an 8% drop in the incidence of overall treatments for ESRD. A particularly marked decline in outpatient dialysis initiation programs (PD and HDD). In addition, the interruption of transplant programs in academic centers as well as the closure of ambulatory patient clinics in a majority of hospitals was associated with a delay in nephrological management.

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