Impact of Chronic Kidney Disease on Activities of Daily Living in Community-Dwelling Older Adults

Bowling, C. Barrett; Sawyer, Patricia; Campbell, Ruth; Ahmed, Ali; Allman, Richard M.

doi:10.1093/gerona/glr043

Cited by 67 publications

(70 citation statements)

References 30 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…Previous work suggests that a worse degree of CKD is associated with a higher frequency of the frailty syndrome 4,19 and a higher risk of functional decline over time 20,21 . Systematically reviewed trial data confirms that exercise training can improve physical function in patients with CKD 22 , but few trials included very old participants, and it is not clear whether these benefits can be realised in inpatient rehabilitation services, especially given the higher risk of cognitive impairment, infection and vascular events, all of which can interfere with successful rehabilitation.…”

Section: Discussionmentioning

confidence: 99%

Association Between Kidney Function, Rehabilitation Outcome, and Survival in Older Patients Discharged From Inpatient Rehabilitation

Doyle

Sloan

Goodbrand

et al. 2015

American Journal of Kidney Diseases

View full text Add to dashboard Cite

General rightsCopyright and moral rights for the publications made accessible in Discovery Research Portal are retained by the authors and/or other copyright owners and it is a condition of accessing publications that users recognise and abide by the legal requirements associated with these rights.• Users may download and print one copy of any publication from Discovery Research Portal for the purpose of private study or research.• You may not further distribute the material or use it for any profit-making activity or commercial gain.• You may freely distribute the URL identifying the publication in the public portal. Take down policyIf you believe that this document breaches copyright please contact us providing details, and we will remove access to the work immediately and investigate your claim.

show abstract

Section: Discussionmentioning

confidence: 99%

Association Between Kidney Function, Rehabilitation Outcome, and Survival in Older Patients Discharged From Inpatient Rehabilitation

Doyle

Sloan

Goodbrand

et al. 2015

American Journal of Kidney Diseases

View full text Add to dashboard Cite

show abstract

“…Prior studies have shown weaker associations between eGFR and adverse events and a lower correlation between kidney function and evidence of nephrosclerosis on renal biopsy among older adults (31,32). However, more recent studies clearly demonstrate that moderate reductions in eGFR are associated with adverse outcomes and a disproportionately higher prevalence of frailty, cognitive impairment, and functional decline (3,5,6). In meta-analyses conducted by the Chronic Kidney Disease Prognosis Consortium of general population and high-risk cohorts, eGFR Ͻ60 ml/min per 1.73 m 2 was associated with increased all-cause and cardiovascular mortality among adults Ͻ65 years of age as well as their counterparts Ն65 years of age (33,34).…”

Section: Discussionmentioning

confidence: 99%

“…In the National Health and Nutrition Examination Survey (NHANES) 1999 to 2004, the prevalence of reduced eGFR (Ͻ60 ml/min per 1.73 m 2 ) was 37.8% among participants more than 70 years old (1). Importantly, for older adults, reduced eGFR has been shown to be associated with higher rates of mortality, cardiovascular disease, and geriatric conditions such as functional decline, frailty, and cognitive impairment (2)(3)(4)(5)(6).…”

Section: Introductionmentioning

confidence: 99%

Age-Specific Associations of Reduced Estimated Glomerular Filtration Rate with Concurrent Chronic Kidney Disease Complications

Bowling

Inker

Gutiérrez

et al. 2011

Clinical Journal of the American Society of Nephrology

View full text Add to dashboard Cite

SummaryBackground and objectives It has been suggested that moderate reductions in estimated GFR (eGFR) among older adults may not reflect chronic kidney disease (CKD).Design, setting, participants, & measurements We examined age-specific (Ͻ60, 60 to 69, 70 to 79, and Ն80 years) associations between eGFR level and six concurrent CKD complications among 30,528 participants from the National Health and Nutrition Examination Survey (NHANES) 1988(NHANES) to 1994(NHANES) and 1999(NHANES) to 2006 (n ϭ 8242 from NHANES 2003 to 2006 for hyperparathyroidism). Complications included anemia (hemoglobin Ͻ12 g/dl women, Ͻ13.5 g/dl men), acidosis (bicarbonate Ͻ22 mEq/L), hyperphosphatemia (phosphorus Ն4.5 mg/dl), hypoalbuminemia (albumin Ͻ3.5 mg/dl), hyperparathyroidism (intact parathyroid hormone Ն70 pg/ml), and hypertension (systolic/diastolic BP Ն140/90 mmHg or antihypertensive use).Results Among participants Ն80 years old, compared with those with estimated GFR (eGFR) Ն60 ml/min per 1.73 m 2 , the multivariable adjusted prevalence ratios (95% confidence interval) associated with eGFR levels of 45 to 59 and Ͻ45 ml/min per 1.73 m 2 were 1.39 (1.11 to1.73) and 2.06 (1.59 to 2.67) for anemia, 1.33 (0.89 to 1.98) and 2.47 (1.52 to 4.00) for acidosis, 1.11 (0.70 to 1.76) and 2.16 (1.36 to 3.42) for hyperphosphatemia, 2.04 (1.39 to 3.00) and 2.83 (1.76 to 4.53) for hyperparathyroidism and 1.09 (1.03 to 1.14), and 1.12 (1.05 to 1.19) for hypertension, respectively. Higher prevalence ratios for these complications at lower eGFR levels were also present at younger ages. Reduced eGFR was associated with hypoalbuminemia only for adults Ͻ70. ConclusionsReduced eGFR was associated with a higher prevalence of several concurrent CKD complications, regardless of age.

show abstract

“…In comparison with those with normal renal function, the elderly patients with CKD are more likely to have increased co-morbidities, walking impairments and decrement in quality of life. Older subjects with GFR less than 45 mL/min/1.73 m 2 have an odds of IADL or basic activities of daily living (BADL) decline more than threefold greater compared with those without CKD [7]. Furthermore community-dwelling older adults with CKD show an accelerate decline in life-space mobility trajectory that produces reduced ability to move to outside one's home, neighborhood, or town and to engage in social activities and participation including family events and religious services [22].…”

Section: Chronic Kidney Disease and Disabilitymentioning

confidence: 99%

“…Furthermore, the number of people with diabetes worldwide, currently around 154 million, is set to double within the next 20 years, and the increase will be most notable in the developing world. The progression of CKD cause functional limitations and severe disability with poor quality of life that require proper rehabilitative strategies, particularly in old people [7] who also suffer from several co-morbidities. The transition from CKD to ESRD constitute high clinical risk situations with substantial healthcare costs.…”

Section: Introductionmentioning

confidence: 99%

The Rehabilitation Role in Chronic Kidney and End Stage Renal Disease

Intiso

2014

Kidney Blood Press Res

121

View full text Add to dashboard Cite

Chronic kidney disease (CKD) worldwide is rising markedly becoming a priority public health problem. The progression of CKD cause functional limitation and severe disability with poor quality of life. The aim of present review was to highlight the effect of rehabilitation in CKD and ESRD subjects. The rehabilitative process is unique in treating disabled people according to a holistic approach with the aim of supporting a person's independent living and autonomy. CKD are associated with an increased risk of functional impairment, independent of age, gender, and co-morbidities. Clinicians should counsel patients with CKD including frail elder people to increase physical activity levels and target that regular physical activity including aerobic or endurance exercises training benefits health. In old subjects with CKD and multiple functional impairments, the traditional disease based model should be changed to individualized patient-centered approach that prioritizes patient preferences. Patients receiving haemodialysis have a considerably lower exercise tolerance, functional capacity, and more muscle wasting than healthy subjects or patients with less severe CKD. Exercise training or comprehensive multi-dimensional strategy and goal-oriented intervention should be also provided in ESRD older subjects. Structured prevention programs based on reducing the risk factors for CKD and rehabilitative strategies could reduce disability occurrence.

show abstract

Impact of Chronic Kidney Disease on Activities of Daily Living in Community-Dwelling Older Adults

Abstract: In community-dwelling older adults, CKD is associated with IADL and BADL decline.

Cited by 67 publications

References 30 publications

Association Between Kidney Function, Rehabilitation Outcome, and Survival in Older Patients Discharged From Inpatient Rehabilitation

Association Between Kidney Function, Rehabilitation Outcome, and Survival in Older Patients Discharged From Inpatient Rehabilitation

Age-Specific Associations of Reduced Estimated Glomerular Filtration Rate with Concurrent Chronic Kidney Disease Complications

The Rehabilitation Role in Chronic Kidney and End Stage Renal Disease

Contact Info

Product

Resources

About