Background. Renal replacement therapy (RRT) is a public health problem worldwide. Kidney transplantation (KT) is the best treatment for elderly patients’ longevity and quality of life. Objectives. The primary endpoint was to compare elderly versus younger KT recipients by analyzing the risk covariables involved in worsening renal function, proteinuria, graft loss, and death one year after KT. The secondary endpoint was to create a robot based on logistic regression capable of predicting the likelihood that elderly recipients will develop worse renal function one year after KT. Method. Unicentric retrospective analysis of a cohort was performed with individuals aged ≥60 and <60 years old. We analysed medical records of KT recipients from January to December 2017, with a follow-up time of one year after KT. We used multivariable logistic regression to estimate odds ratios for elderly vs younger recipients, controlled for demographic, clinical, laboratory, data pre- and post-KT, and death. Results. 18 elderly and 100 younger KT recipients were included. Pretransplant immune variables were similar between two groups. No significant differences (P>0.05) between groups were observed after KT on laboratory data means and for the prevalences of diabetes mellitus, hypertension, acute rejection, cytomegalovirus, polyomavirus, and urinary infections. One year after KT, the creatinine clearance was higher (P = 0.006) in youngers (70.9 ± 25.2 mL/min/1.73 m2) versus elderlies (53.3 ± 21.1 mL/min/1.73 m2). There was no difference in death outcome comparison. Multivariable analysis among covariables predisposing chronic kidney disease epidemiology collaboration (CKD-EPI) equation <60 mL/min/1.73 m2 presented a statistical significance for age ≥60 years (P = 0.01) and reduction in serum haemoglobin (P = 0.03). The model presented goodness-fit in the evaluation of artificial intelligence metrics (precision: 90%; sensitivity: 71%; and F1 score: 0.79). Conclusion. Renal function in elderly KT recipients was lower than in younger KT recipients. However, patients aged ≥60 years maintained enough renal function to remain off dialysis. Moreover, a learning machine application built a robot (Elderly KTbot) to predict in the elderly populations the likelihood of worse renal function one year after KT.
Background: Chronic kidney disease is a financial challenge for global public health due to rising costs, a poorer quality of life. Globally, there has been an increase in the number of diabetic, hypertensive and obese patients, with a tendency to rise as life expectancy increases. Objective: To assess the quality of life of patients with chronic kidney disease on hemodialysis at a satellite clinic in Recife, Northeast Brazil, and comparing low-income patients funded by the national healthcare system with middle- and higher-income patients funded by private health insurance. Methods: The Medical Outcomes Study Questionnaire Short Form 36 Health Survey (SF-36) was applied, together with a complementary interview with socio-demographic data for all patients at a conventional hemodialysis clinic. All patients were submitted to the same hemodialysis protocol, 4 hours and 10 minutes, high flow biocompatible membranes with high mass transfer coefficient and an adequacy of Kt/V ≥1.2. Results: The poorest quality of life scores with the SF-36 were related to physical functioning and pain. The best scores were attributed to mental health, social functioning, general health and vitality with no differences between the household incomes. There was a positive association between education, role-emotional and physical functioning. Longer hemodialysis treatment times demonstrated a positive association with aspects of general health. Patients who had undergone hemodialysis between one and five years presented better quality of life scores with the SF-36. Conclusions: Hemodialysis treatment negatively influences the quality of life of patients with chronic kidney disease. Education seems to help patients to better understand and accept treatment, by raising the scores of the physical functioning and role-physical. The first year of hemodialysis seems to exert a more negative influence on the quality of life. Among all patients, pain and physical aspects seem to be the critical points, regardless of social class or income.
scite is a Brooklyn-based organization that helps researchers better discover and understand research articles through Smart Citations–citations that display the context of the citation and describe whether the article provides supporting or contrasting evidence. scite is used by students and researchers from around the world and is funded in part by the National Science Foundation and the National Institute on Drug Abuse of the National Institutes of Health.
hi@scite.ai
334 Leonard St
Brooklyn, NY 11211
Copyright © 2024 scite LLC. All rights reserved.
Made with 💙 for researchers
Part of the Research Solutions Family.