scholarly journals 122CLINICIAN ATTITUDES REGARDING THE UTILITY OF FRAILTY TOOLS IN MANAGING OLDER ADULTS WITH END STAGE KIDNEY DISEASE: LITERATURE REVIEW AND SURVEY STUDY

2019 ◽  
Vol 48 (Supplement_1) ◽  
pp. i32-i35
Author(s):  
A P W Kumarasinghe ◽  
C Inderjeeth ◽  
S Maher ◽  
A Chakera ◽  
S Dogra ◽  
...  
Keyword(s):  
Older Adults ◽  
Kidney Disease ◽  
Literature Review ◽  
Survey Study ◽  
End Stage Kidney Disease ◽  
End Stage

scholarly journals Costs and outcomes of advance care planning and end-of-life care for older adults with end-stage kidney disease: A person-centred decision analysis

PLoS ONE ◽  
2019 ◽  
Vol 14 (5) ◽  
pp. e0217787 ◽  
Author(s):  
Marcus Sellars ◽  
Josephine M. Clayton ◽  
Karen M. Detering ◽  
Allison Tong ◽  
David Power ◽  
...  
Keyword(s):  
Older Adults ◽  
Kidney Disease ◽  
Decision Analysis ◽  
Advance Care Planning ◽  
End Of Life Care ◽  
Care Planning ◽  
Life Care ◽  
End Stage Kidney Disease ◽  
Advance Care ◽  
End Stage

scholarly journals A Qualitative Pilot Study of the Perceptions in Older Adults with End-Stage Kidney Disease on Hemodialysis*

2019 ◽  
Vol 22 (2) ◽  
Author(s):  
Seki A. Balogun ◽  
Natalie B. May ◽  
Meagan Briley ◽  
Allison Bosch ◽  
Isabelle Duerr ◽  
...  
Keyword(s):  
Older Adults ◽  
Kidney Disease ◽  
Coping Strategies ◽  
Chronic Hemodialysis ◽  
End Stage Kidney Disease ◽  
Patient Centered ◽  
Positive Coping ◽  
End Stage ◽  
Trust In Physicians ◽  
And Coping

BackgroundLittle is known about the perceptions of older adults with end-stage kidney disease (ESKD) on chronic hemodialysis (HD) even though this could potentially influence how treatment is received. This study explores the perceptions of older adults with ESKD on HD, specifically their decision to initiate HD, preconceptions and expectations of HD, perceived difficulties with HD, and coping strategies.Design: Cross–sectionalSetting: Outpatient chronic dialysis units Participants: Older adults with ESKD on HD Intervention: Open-ended interviews were conducted with 15 participants. Inclusion criteria were age 60 years and older, HD duration of at least three months, and ability to consent and participate in the interview process.Results: We report on four identified domains: decision to initiate HD; preconceptions and expectations of HD; drawback of HD; and coping strategies. All participants were reluctant to initiate HD, but made the decision on advice from their physicians for varying reasons. Trust in physicians’ opinions also played a role for some. Some participants had positive preconceptions of HD, while a few had negative preconceptions or unrealistic expectations. Even though the majority of participants identified several difficulties with being on HD, they also had positive coping strategies, and the majority indicated that they would make the same decision to initiate HD.Conclusion: As clinicians are turning more to patient-centered medicine, understanding patients’ perceptions of HD is of crucial importance. Our study highlights the importance of improving pre-hemodialysis education to ensure that patients’ expectations are realistic, as well as identifying individualized coping strategies by patients. 

scholarly journals Patient Decision Aid Development for Older Adults With End-Stage Kidney Disease in Singapore

2021 ◽  
Author(s):  
Semra Ozdemir ◽  
Lina Hui Lin Choong ◽  
Shien Wen Sheryl Gan ◽  
Lydia Wei Lim ◽  
Chetna Malhotra ◽  
...  
Keyword(s):  
Older Adults ◽  
Kidney Disease ◽  
Decision Aid ◽  
Patient Decision Aid ◽  
End Stage Kidney Disease ◽  
Patient Decision ◽  
End Stage

scholarly journals The impact of end-stage kidney disease (ESKD) on close persons: a literature review

2008 ◽  
Vol 1 (2) ◽  
pp. 67-79 ◽  
Author(s):  
J. Low ◽  
G. Smith ◽  
A. Burns ◽  
L. Jones
Keyword(s):  
Kidney Disease ◽  
Literature Review ◽  
End Stage Kidney Disease ◽  
End Stage ◽  
The Impact

scholarly journals A randomized pilot study to evaluate graft versus fistula vascular access strategy in older patients with advanced kidney disease: results of a feasibility study 

2020 ◽  
Author(s):  
Mariana Murea ◽  
Randolph L Geary ◽  
Denise K Houston ◽  
Matthew S Edwards ◽  
Todd W Robinson ◽  
...  
Keyword(s):  
Older Adults ◽  
Chronic Kidney Disease ◽  
Kidney Disease ◽  
Arteriovenous Fistula ◽  
Vascular Access ◽  
Arteriovenous Graft ◽  
End Stage Kidney Disease ◽  
Arteriovenous Access ◽  
End Stage

Abstract Background. Although older adults encompass almost half of patients with advanced chronic kidney disease, it remains unclear which long-term hemodialysis vascular access type, arteriovenous fistula or arteriovenous graft, is optimal with respect to effectiveness and patient satisfaction. Clinical outcomes based on the initial AV access type have not been evaluated in randomized controlled trials. This pilot study tested the feasibility of randomizing older adults with advanced kidney disease to initial arteriovenous fistula versus graft vascular access surgery.Methods: Patients 65 years or older with pre-dialysis chronic kidney disease or incident end-stage kidney disease and no prior arteriovenous vascular access intervention were randomized in a 1:1 ratio to undergo surgical placement of a fistula or a graft after providing informed consent. Trial feasibility was evaluated as (i) recruitment of ≥70% of eligible participants, (ii) ≥50% to 70% of participants undergo placement of index arteriovenous access within 90 to 180 days of enrollment, respectively, (iii) ≥80% adherence to study-related assessments, and (iv) ≥70% of participants who underwent index arteriovenous access placement will have a follow-up duration of ≥12 months after index surgery date.Results: Between September 2018 and October 2019, 81% (44/54) of eligible participants consented and were enrolled in the study; 11 had pre-dialysis chronic kidney disease and 33 had incident or prevalent end-stage kidney disease. After randomization, 100% (21/21) assigned to arteriovenous fistula surgery and 78% (18/23) assigned to arteriovenous graft surgery underwent index arteriovenous access placement within a median (1st, 3rd quartile) of 5.0 (1.0, 14.0) days and 13.0 (5.0, 44.3) days, respectively, after referral to vascular surgery. The completion rates for study-specific assessments ranged between 40.0 and 88.6%. At median follow-up of 215.0 days, 5 participants expired, 7 completed 12 months of follow-up, and 29 are actively being followed. Assessments of grip strength, functional independence and vascular access satisfaction were completed by >85% of patients who reached pre-specified post-operative assessment time point.Conclusions: Results from this study reveal it is feasible to enroll and randomize older adults with advanced kidney disease to one of two different arteriovenous vascular access placement surgeries. The study can progress with minor protocol adjustments to a multisite clinical trial.Trial registration: Clinical Trials ID: NCT03545113. Registered June 4, 2018.

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