scholarly journals Classification of Chronic Kidney Disease in the Elderly: Pitfalls and Errors

2011 ◽  
Vol 119 (s1) ◽  
pp. c2-c4 ◽  
Author(s):  
Christopher G. Winearls ◽  
Richard J. Glassock
Keyword(s):  
Chronic Kidney Disease ◽  
Kidney Disease ◽  
The Elderly

scholarly journals Classification of patients at risk for chronic kidney disease by use of eGFR and albuminuria

2015 ◽  
Vol 9 (1) ◽  
Author(s):  
Jelena Seferović ◽  
Višnja Ležaić
Keyword(s):  
Chronic Kidney Disease ◽  
At Risk ◽  
High Risk ◽  
Kidney Disease ◽  
Blood Pressure Measurement ◽  
Staging System ◽  
The Elderly ◽  
High Risk Group ◽  
Hypertensive Patients

Introduction. Screening for chronic kidney disease (CKD) has been advisedin high-risk populations. However, data on the prevalence of early asymptomaticstages vary and depend on the definition of CKD. In the present studysubjects at risk for CKD (patients with diabetes mellitus type 2-DM2, withhypertension and older than 60 years without diabetes and hypertension)were classified in categories defined by eGFR and albuminuria staging system.Methods. After regular check-up in primary health center, 285 consecutivepatients at risk for CKD, were selected: 75 patients with well-controlled DM2without hypertension, 130 with hypertension and 80 subjects older than 60years without diabetes or hypertension. Screening included a questionnaire,blood pressure measurement, single albuminuria determined by immunonephelometry,and eGFR estimation using MDRD.Results. Six DM2 patients, 15 withe hyprtension and 12 elderly had eGFR<60(assessed in ml/min/1.73m2) with optimal albuminuria. High albuminuriawas observed in one DM2 and four hypertensive patients, and 28 elderly.When eGFR and albuminuria staging system for predicting risk for majorCKD outcomes was used, 41.2% of the elderly were classified in the moderateand 8.8% in the high risk group, for DM2 patients these percentages were9.3% and 0%, and for hypertensive patients 16.9% and 4.7%, respectively.Conclusion. The majority of examined patients did not have CKD, and in allthree groups most individuals with reduced eGFR did not have albuminuria>30mg/g. Using the classification of CKD based on eGFR and albuminuria,

Clinical classification of hyperuricemia in patients with chronic kidney disease

2021 ◽  
Author(s):  
Fengqin Li ◽  
Hui Guo ◽  
Jianan Zou ◽  
Chensheng Fu ◽  
Song Liu ◽  
...  
Keyword(s):  
Chronic Kidney Disease ◽  
Kidney Disease ◽  
Clinical Classification

scholarly journals P0296LAST HIT ‘' INFECTIONS'’ BROUGHT THE END: CHRONIC KIDNEY DISEASE TO RENAL REPLACEMENT TREATMENT

2020 ◽  
Vol 35 (Supplement_3) ◽  
Author(s):  
Feyza Bora ◽  
Emine Asar ◽  
Fatih Yılmaz ◽  
Ümit Çakmak ◽  
Fevzi F Ersoy ◽  
...  
Keyword(s):  
Chronic Kidney Disease ◽  
Kidney Disease ◽  
Outpatient Clinic ◽  
Artery Bypass ◽  
Kidney Injury ◽  
The Elderly ◽  
Severe Form ◽  
Vaccination Programs ◽  
Cardiac Decompensation ◽  
Replacement Treatment

Abstract Background and Aims It is evident that Chronic Kidney Disease (CKD) influences the risk of developing AKI (Acute Kidney Injury) and recent studies suggest that CKD patients who experienced an episode of AKI are more likely to progress to end stage renal disease (ESRD) than patients without CKD. AKI-CKD association might originate from common comorbidities associated with both AKI and CKD, such as diabetes and/or hypertension, and concurrent increase in interventions leading to frequent exposure to various nephrotoxins. AKI in the elderly has been shown to increase the risk of progression to CKD to ESRD. AKI is common in critically ill patients, and those patients with the most severe form of AKI, requiring RRT, have a mortality rate of 50–80 %. Patients with an eGFR &lt;45 ml/min per 1.73m2 who experienced an episode of dialysis-requiring AKI were at very high risk for impaired recovery of renal function. Our aim was to determine the reasons that initiate hemodialysis (renal decompensation) in patients with regular follow-up in the low clearance polyclinic without renal replacement treatment (RRT). Method The retrospective study included predialysis CKD patients who had followed up regularly and had undergone RRT in recent 4 years. Data on baseline characteristics and medical history were obtained from patient hospital records. Results Of the 228 patients, 155 (68%) were male and 73 (32%) were female. The mean age was 58 years (45-66). Diabetes Mellitus was the first in the etiology of CKD (26,3 %), the second was unknown (12,7 %), the third was hypertension (11,8 %). 145 patients (63,6%) underwent regular hemodialysis (HD) (62 years, 55-69), 25 patients (11%) began peritoneal dialysis (PD), 58 patients (25%) had renal transplantation. 52 patients underwent HD with renal decompensation, 22 (%42,3) had working arteriovenous fistula (AVF). There was no decompensation in patients with PD or transplantation plan. 34 patients started HD because of infections (65%), 8 patients (15%) after operations (4 was Coronary Artery Bypass Grafting-CABG), 6 patients (%11,5) after coronary angiography, 4 patients (7,5%) with cardiac decompensation. 2 patients died during the hospitalisation for infections. Of 145 HD patients, 89 (%61,4) had AVF. The patients who had renal decompensation were more older 63 (58-70), have lower Hgb 9,7 g/L (9,1-10,7) and albumin 3,5 g/L (3,2-3,9) level (p&lt;0,05). There was no difference in eGFR at the beginning of HD between renal decompensation and other HD patients. 42 patients did not undergo HD at the time we suggested during visits. Of them 9 patients (%21) had renal decompensation (6 infections,3 CABG), 17 patients (%40) had AVF. 3 of them died. The others underwent HD for uremic complications. Conclusion We have shown that infections are as the leading cause of renal decompensation. Most of our patients who started to RRT from our low clearance outpatient clinic have chosen HD for RRT. Prevention of infections via vaccination programs or early diagnosis at regular policlinic or telephone visits, and informing patients adequately about nephrotoxic drugs or the conditions that may cause renal decompensation are among the first tasks of the predialysis outpatient clinic. Transition of CKD patients to RRTs, with proper preparation, neither late nor early- at the most appropriate time- should be among in our goals. This may reduce the cost of ESRD patients.

scholarly journals Effects of Diet Intervention on Body Composition in the Elderly with Chronic Kidney Disease

2017 ◽  
Vol 14 (8) ◽  
pp. 735-740 ◽  
Author(s):  
Kai-Yin Hung ◽  
Terry Ting-Yu Chiou ◽  
Chien-Hsing Wu ◽  
Ying-Chun Liao ◽  
Chian-Ni Chen ◽  
...  
Keyword(s):  
Chronic Kidney Disease ◽  
Body Composition ◽  
Kidney Disease ◽  
The Elderly ◽  
Diet Intervention

scholarly journals Classification of Chronic Kidney Disease Biomarkers to Predict Coronary Artery Calcium

2012 ◽  
Vol 36 (1) ◽  
pp. 26-35 ◽  
Author(s):  
Sterling McPherson ◽  
Celestina Barbosa-Leiker ◽  
Robert Short ◽  
Katherine R. Tuttle
Keyword(s):  
Chronic Kidney Disease ◽  
Coronary Artery ◽  
Kidney Disease ◽  
Coronary Artery Calcium ◽  
Disease Biomarkers

Association of age with risk of major depression among patients with chronic kidney disease over midlife: a nationwide cohort study in Taiwan

2018 ◽  
Vol 31 (08) ◽  
pp. 1171-1179 ◽  
Author(s):  
Shih-Feng Chen ◽  
Yu-Huei Chien ◽  
Pau-Chung Chen ◽  
I-Jen Wang
Keyword(s):  
Chronic Kidney Disease ◽  
Cohort Study ◽  
Major Depression ◽  
Kidney Disease ◽  
Comparison Group ◽  
Age Groups ◽  
International Classification Of Diseases ◽  
Classification Of Diseases ◽  
The Impact

ABSTRACTBackground:The impact of age on the development of depression among patients with chronic kidney disease (CKD) at stages before dialysis is not well known. We aimed to explore the incidence of major depression among predialysis CKD patients of successively older ages through midlife.Methods:We conducted a retrospective cohort study using the longitudinal health insurance database 2005 in Taiwan. This study investigated 17,889 predialysis CKD patients who were further categorized into study (i.e. middle and old-aged) groups and comparison group aged 18–44. The International Classification of Diseases, Ninth Revision, Clinical Modification (ICD-9-CM) was applied for coding diseases.Results:The group aged 75 and over had the lowest (hazard ratio [HR] 0.47; 95% confidence interval [CI] 0.32–0.69) risk of developing major depression, followed by the group aged 65–74 (HR 0.67; 95% CI 0.49–0.92), using the comparison group as reference. The adjusted survival curves showed significant differences in cumulative major depression-free survival between different age groups. We observed that the risk of major depression development decreases with higher age. Females were at a higher risk of major depression than males among predialyasis CKD patients.Conclusions:The incidence of major depression declines with higher age in predialysis CKD patients over midlife. Among all age groups, patients aged 75 and over have the lowest risk of developing major depression. A female preponderance in major depression development is present. We suggest that depression prevention and therapy should be integrated into the standard care for predialysis CKD patients, especially for those young and female.

scholarly journals Chronic kidney disease in the elderly: evaluation and management

2014 ◽  
Vol 11 (5) ◽  
pp. 525-535 ◽  
Author(s):  
Mary Mallappallil ◽  
Eli A Friedman ◽  
Barbara G Delano ◽  
Samy I McFarlane ◽  
Moro O Salifu
Keyword(s):  
Chronic Kidney Disease ◽  
Kidney Disease ◽  
The Elderly

scholarly journals Amiodarone Toxicity Screening: What are the Clinicians Supposed to Tell Patients

2020 ◽  
pp. 1-5
Author(s):  
John D Rozich ◽  
Keyword(s):  
Atrial Fibrillation ◽  
Chronic Kidney Disease ◽  
Clinical Practice ◽  
Kidney Disease ◽  
Low Dose ◽  
The Elderly ◽  
Toxicity Screening ◽  
Nonvalvular Atrial Fibrillation ◽  
Routine Testing ◽  
Continued Use

The use of amiodarone in clinical practice continues to be widespread in the setting of nonvalvular atrial fibrillation (NVAF). Use of amiodarone continues especially in the elderly where the drug’s favorable characteristics and outcomes in the setting of chronic kidney disease coupled to its low inherent proarrhythmic profile has ensured its continued use. The present work focuses on the information that clinicians should tell their patients regarding requisite toxicity screening during daily treatment with amiodarone when it is maintained at a low dose of 200 mgs per day or less. Several questions need be answered in pursuit of the fundamental query as to whether routine testing for toxicity should still be advised. Most importantly, has ongoing screening shown to be of any proven value?

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