scholarly journals CHRONIC KIDNEY DISEASE, MUSCLE WEAKNESS, AND MOBILITY LIMITATION

2019 ◽  
Vol 3 (Supplement_1) ◽  
pp. S523-S523
Author(s):  
Kenzie Latham-Mintus ◽  
Simit Doshi ◽  
Ranjani Moorthi
Keyword(s):  
Older Adults ◽  
Chronic Kidney Disease ◽  
Kidney Disease ◽  
Muscle Strength ◽  
Muscle Weakness ◽  
Physical Functioning ◽  
Demographic Characteristics ◽  
Mobility Limitations ◽  
Nationally Representative ◽  
Walking Speeds

Abstract Objectives: Chronic kidney disease (CKD) is associated with increased mobility limitation. Prior research has documented that peripheral nerve abnormalities occur early in CKD and progressively worsen. Loss of balance, impaired muscle strength, and slow gait predispose older adults to falls and frailty. However, the current literature is limited by a lack of nationally representative data that includes objective measures of kidney disease and physical functioning. Thus, this research examines whether CKD is associated with muscle strength, balance, gait, and self-reported mobility limitations. Methods: Data come from the 2016 Health and Retirement Study (HRS). Estimated GFR, a measure of kidney functioning derived from creatinine levels in the blood, was used to classify CKD (i.e, eGFR<45 or Stage 3b CKD). Logistic and linear regression models were generated to examine the association of CKD with physical functioning, net of demographic characteristics (i.e., age, sex, race, and education) and comorbidities (i.e., obesity, pain, and number of diagnosed medical conditions). Results: In unadjusted models, CKD was significantly associated (p<0.05) with more mobility limitations, slower walking speeds, stronger grip strengths, and non-participation in balance tests. After adjusting for covariates, CKD (β=-1.43, p=0.01) was negatively associated with grip strength. In sex-stratified models, CKD was associated with slower walking speeds among men, whereas CKD was associated with more mobility limitations among women. Discussion: In a nationally representative sample of older adults, CKD was associated with poorer physical functioning on multiple measures. After adjusting for demographic characteristics and comorbidities, CKD was associated with increased muscle weakness.

scholarly journals Is the peripheral muscle weakness a limitation to exercise on chronic kidney disease?

2020 ◽  
Vol 33 ◽  
Author(s):  
Davi de Souza Francisco ◽  
Ana Karla Vieira Brüggemann ◽  
Tarcila Dal Pont ◽  
Mariana Nunes Lúcio ◽  
Elaine Paulin
Keyword(s):  
Chronic Kidney Disease ◽  
Kidney Disease ◽  
Muscle Strength ◽  
Exercise Capacity ◽  
Muscle Weakness ◽  
Lower Limb ◽  
Public Health Problem ◽  
Healthy Individuals ◽  
Peripheral Muscle ◽  
Left Limb

Abstract Introduction: Chronic kidney disease (CKD) is a global public health problem with systemic repercussions, compromising muscle function and making patients less exercise tolerant. Objective: To verify the contribution of peripheral muscle strength in the exercise capacity of patients in hemodialysis (HD), as well as to compare peripheral muscle strength and exercise capacity between renal patients and healthy individuals. Method: 50 patients with chronic kidney disease (CKD) who performed HD and 13 healthy subjects underwent anthropometric evaluation, evaluation of peripheral muscle strength, pulmonary function test and exercise capacity assessment. Results: Simple linear regression indicated that the peripheral muscle strength contributed 41.4% to the distance walked in the six-minute walk test (R2 0.414; p < 0.001), showing that for every 1 Kgf reduced in the right lower limb the patient it stops walking 0.5m while for every 1 Kgf reduced in the lower left limb the patient stops walking 0.8m. In addition, it was observed that patients with CKD had a reduction in right lower limb muscle strength (129.44 ± 48.05 vs. 169.36 ± 44.30, p = 0.002), left (136.12 ± 52, 08 vs 168.40 ± 43.35, p = 0.01) and exercise capacity (421.20 ± 98.07 vs. 611.28 ± 80.91, p < 0.001) when compared to healthy pairs. Conclusion: Peripheral muscle weakness is an important limiting factor for exercise in CKD and patients on HD experience a decline in peripheral muscle strength and exercise capacity when compared to healthy individuals.

Physical Activity Intensity and Biopsychosocial Correlates in Chinese Middle-Aged and Older Adults With Chronic Kidney Disease

2019 ◽  
Vol 27 (6) ◽  
pp. 871-878
Author(s):  
Jieling Chen ◽  
Emily Joy Nicklett ◽  
Yaping He ◽  
Vivian W.Q. Lou
Keyword(s):  
Physical Activity ◽  
Older Adults ◽  
Chronic Kidney Disease ◽  
Kidney Disease ◽  
Urban Areas ◽  
Mobility Limitations ◽  
Physical Activity Intensity ◽  
Middle Aged ◽  
Activity Intensity ◽  
Light Activity

The study aims to characterize physical activity (PA) participation by intensity and examine the biopsychosocial correlates among middle-aged and older adults with chronic kidney disease (CKD) in China. Data were examined from the 2011 China Health and Retirement Longitudinal Study. The percentages of participation in vigorous, moderate, and light activity among participants with CKD were 22.7%, 42.1%, and 76.3%, respectively. The participants were less likely to engage in vigorous and moderate PA if they were 70 years of age or older, were not married/partnered, were unemployed, lived in urban areas, had an advanced stage of disease, had heart disease, and/or experienced mobility limitations. The magnitude of the associations between biophysical factors and PA participation was small for light PA. The higher the intensity of regular PA, the less likely older adults with CKD were to participate. Practitioners could consider the psychosocial characteristics of the older adults with CKD and facilitate their participation in PA.

Spontaneous self-affirmation before and during COVID-19: Associations with information-seeking, worry and adherence

2020 ◽  
Author(s):  
Tracy Epton ◽  
Chris Keyworth ◽  
Chris Armitage
Keyword(s):  
Older Adults ◽  
Opposite Direction ◽  
Information Seeking ◽  
Demographic Characteristics ◽  
Brief Interventions ◽  
Adaptive Behaviors ◽  
Uk Government ◽  
Nationally Representative

Objective: To assess the extent of spontaneous self-affirmation pre COVID-19 and during COVID-19 pandemic to identify for whom self-affirmation interventions might be helpful; and the extent to which spontaneous self-affirmation is associated with increased information-seeking, worry and adherence to UK government instructions. Methods: Two large nationally-representative surveys of UK adults were conducted via YouGov in March 2019 (pre COVID-19; N = 10421) and April 2020 (during COVID-19; N = 2252); both surveys measured demographic characteristics and spontaneous self-affirmation. The latter survey included measures of time spent accessing COVID-19 related news, worry about COVID-19 related news and degree of adherence to UK government instructions. Results: Spontaneous self-affirmation was lower before COVID-19 (44%) than it was during the pandemic (57%), although the pattern was in the opposite direction among older adults. Older adults were more likely to spontaneously self-affirm during COVID-19 than pre COVID-19. Greater spontaneous self-affirmation was associated with more time spent accessing news, and greater adherence to UK government instructions, but not media-related worry. Conclusions: The threat of COVID-19 may have triggered greater levels of spontaneous self-affirmation, which could give people the resources they needed to allow them to seek COVID-19-related news and adhere to UK government instructions. Groups lower in spontaneous self-affirmation, such as younger people could be targeted with brief interventions to promote self-affirmation and encourage performance of adaptive behaviors.

scholarly journals Pharmacist-Led Collaborative Medication Management for the Elderly with Chronic Kidney Disease and Polypharmacy

2021 ◽  
Vol 18 (8) ◽  
pp. 4370
Author(s):  
A Kim ◽  
Hayeon Lee ◽  
Eun-Jeong Shin ◽  
Eun-Jung Cho ◽  
Yoon-Sook Cho ◽  
...  
Keyword(s):  
Older Adults ◽  
Chronic Kidney Disease ◽  
Kidney Disease ◽  
Medication Management ◽  
Medication Use ◽  
Potentially Inappropriate Medications ◽  
Management Service ◽  
Ckd Stage ◽  
The Impact

Inappropriate polypharmacy is likely in older adults with chronic kidney disease (CKD) owing to the considerable burden of comorbidities. We aimed to describe the impact of pharmacist-led geriatric medication management service (MMS) on the quality of medication use. This retrospective descriptive study included 95 patients who received geriatric MMS in an ambulatory care clinic in a single tertiary-care teaching hospital from May 2019 to December 2019. The average age of the patients was 74.9 ± 7.3 years; 40% of them had CKD Stage 4 or 5. Medication use quality was assessed in 87 patients. After providing MMS, the total number of medications and potentially inappropriate medications (PIMs) decreased from 13.5 ± 4.3 to 10.9 ± 3.8 and 1.6 ± 1.4 to 1.0 ± 1.2 (both p < 0.001), respectively. Furthermore, the number of patients who received three or more central nervous system-active drugs and strong anticholinergic drugs decreased. Among the 354 drug-related problems identified, “missing patient documentation” was the most common, followed by “adverse effect” and “drug not indicated.” The most frequent intervention was “therapy stopped”. In conclusion, polypharmacy and PIMs were prevalent in older adults with CKD; pharmacist-led geriatric MMS improved the quality of medication use in this population.

scholarly journals Everyday Discrimination and Kidney Function Among Older Adults: Evidence From the Health and Retirement Study

2019 ◽  
Vol 75 (3) ◽  
pp. 517-521
Author(s):  
Ryon J Cobb ◽  
Roland J Thorpe ◽  
Keith C Norris
Keyword(s):  
Older Adults ◽  
Chronic Kidney Disease ◽  
Kidney Disease ◽  
Kidney Function ◽  
The United States ◽  
Health And Retirement Study ◽  
Disease Epidemiology ◽  
Lower Egfr ◽  
Everyday Discrimination ◽  
Retirement Study

Abstract Background With advancing age, there is an increase in the time of and number of experiences with psychosocial stressors that may lead to the initiation and/or progression of chronic kidney disease (CKD). Our study tests whether one type of experience, everyday discrimination, predicts kidney function among middle and older adults. Methods The data were from 10 973 respondents (ages 52–100) in the 2006/2008 Health and Retirement Study, an ongoing biennial nationally representative survey of older adults in the United States. Estimated glomerular filtration rate (eGFR) derives from the Chronic Kidney Disease Epidemiology Collaboration equation. Our indicator of everyday discrimination is drawn from self-reports from respondents. Ordinary Least Squared regression (OLS) models with robust standard errors are applied to test hypotheses regarding the link between everyday discrimination and kidney function. Results Everyday discrimination was associated with poorer kidney function among respondents in our study. Respondents with higher everyday discrimination scores had lower eGFR after adjusting for demographic characteristics (B = −1.35, p &lt; .05), and while attenuated, remained significant (B = −0.79, p &lt; .05) after further adjustments for clinical, health behavior, and socioeconomic covariates. Conclusions Our study suggests everyday discrimination is independently associated with lower eGFR. These findings highlight the importance of psychosocial factors in predicting insufficiency in kidney function among middle-aged and older adults.

Nonprogressive Kidney Dysfunction and Outcomes in Older Adults with Chronic Kidney Disease

2009 ◽  
Vol 57 (12) ◽  
pp. 2217-2223 ◽  
Author(s):  
Balsam El-Ghoul ◽  
Caroline Elie ◽  
Tarek Sqalli ◽  
Paul Jungers ◽  
Michel Daudon ◽  
...  
Keyword(s):  
Older Adults ◽  
Chronic Kidney Disease ◽  
Kidney Disease ◽  
Kidney Dysfunction

scholarly journals Comparison of muscle strength between hemodialysis patients and non-dialysis patients with chronic kidney disease

2021 ◽  
Vol 33 (10) ◽  
pp. 742-747
Author(s):  
Nobuyuki Shirai ◽  
Suguru Yamamoto ◽  
Yutaka Osawa ◽  
Atsuhiro Tsubaki ◽  
Shinichiro Morishita ◽  
...  
Keyword(s):  
Chronic Kidney Disease ◽  
Kidney Disease ◽  
Muscle Strength ◽  
Hemodialysis Patients ◽  
Dialysis Patients

scholarly journals Trajectory of Estimated Glomerular Filtration Rate and Malnourishment Predict Mortality and Kidney Failure in Older Adults With Chronic Kidney Disease

2021 ◽  
Vol 8 ◽  
Author(s):  
Shuo-Chun Weng ◽  
Chyong-Mei Chen ◽  
Yu-Chi Chen ◽  
Ming-Ju Wu ◽  
Der-Cherng Tarng
Keyword(s):  
Older Adults ◽  
Chronic Kidney Disease ◽  
Kidney Disease ◽  
Glomerular Filtration ◽  
Kidney Failure ◽  
Quadratic Term ◽  
Mixed Effect ◽  
Risk Of Death ◽  
Nutritional Risk Index ◽  
Prospective Longitudinal

Objective: The trajectory patterns of estimated glomerular filtration rates (eGFR) in chronic kidney disease (CKD) older adults with malnourishment and their association with subsequent patient outcomes have not been elucidated. We aimed to assess the eGFR trajectory patterns for predicting patient survival and kidney failure in the elderly without or with malnourishment.Materials and Methods: Based on a prospective longitudinal cohort, CKD patients aged 65 years or older were enrolled from 2001 to 2013. Among the 3,948 patients whose eGFR trajectory patterns were analyzed, 1,872 patients were stratified by the absence or presence of malnourishment, and 765 patients were identified and categorized as having malnourishment. Four eGFR trajectory patterns [gradual decline (T0), early non-decline and then persistent decline (T1), persistent increase (T2), and low baseline and then progressive increase (T3)] were classified by utilizing a linear mixed-effect model with a quadratic term in time. The malnourishment was defined as body mass index &lt; 22 kg/m2, serum albumin &lt; 3.0 mg/dL, or Geriatric Nutritional Risk Index (GNRI) &lt; 98. This study assessed the effectiveness of eGFR trajectory patterns in a median follow-up of 2.27 years for predicting all-cause mortality and kidney failure.Results: The mean age was 76.9 ± 6.7 years, and a total of 82 (10.7%) patients with malnourishment and 57 (5.1%) patients without malnourishment died at the end of the study. Compared with the reference trajectory T0, the overall mortality of T1 was markedly reduced [adjusted hazard ratio (aHR) = 0.52, 95% confidence interval (CI) 0.32–0.83]. In patients with trajectory, T3 was associated with a high risk for kidney failure (aHR = 5.68, 95% CI 3.12–10.4) compared with the reference, especially higher risk in the presence of malnourishment. Patients with high GNRI values were significantly associated with a lower risk of death and kidney failure, but patients with malnourishment and concomitant alcohol consumption had a higher risk of kidney failure.Conclusions: Low baseline eGFR and progressively increasing eGFR trajectory were high risks for kidney failure in CKD patients. These findings may be attributed to multimorbidity, malnourishment, and decompensation of renal function.

Management of acute kidney injury and chronic kidney disease

2017 ◽  
pp. 1087-1096
Author(s):  
Natalie Ebert ◽  
Elke Schaeffner
Keyword(s):  
Older Adults ◽  
Chronic Kidney Disease ◽  
Acute Kidney Injury ◽  
Kidney Disease ◽  
Kidney Injury ◽  
Staging System ◽  
Kidney Damage ◽  
The Right ◽  
Stage Renal Disease ◽  
End Stage

Both acute and chronic states of kidney disease have considerable healthcare impact as they can produce enormous disease burden and costs. To classify chronic kidney disease into the CKD staging system, glomerular filtration rate as an index of kidney function, as well as albuminuria as a marker of kidney damage have to be assessed as correctly as possible. Misclassification is a serious concern due to the difficulties in precise GFR assessment and correct interpretation of results. Differentiating between pure senescence and true disease among older adults can be a delicate issue. To find the right renal replacement option for individuals that progress to end-stage renal disease can be challenging, and some older patients may even benefit from conservative care without dialysis. To prevent acute kidney injury as a frequent and potentially life-threatening complication, clinicians need to develop an understanding of the common vulnerability to kidney damage among older adults.

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