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Kidney function and cognitive decline in frail elderly: two faces of the same coin?

Kidney function and cognitive decline in frail elderly: two faces of the same coin? Background and aims Cognitive and renal impairment are pervasive among elderly frails, a high-risk, geriatric sub-popula- tion with peculiar clinical characteristics. In a series of frail individuals with non-advanced chronic kidney disease (CKD), we aimed at assessing the entity of functional, general health and cognitive impairment and the possible relationship between these types of dysfunction and the severity of renal impairment. Methods 2229 geriatric subjects were screened for frailty and CKD. Severity of CKD was assessed by eGFR (CKD-EPI formula). Frailty was established by the Fried Index. Functional, general health and cognitive status were assessed by vali- dated score measures. Results Final analysis included 271 frail CKD subjects (162 women, 109 men). Mean eGFR was 64.25 ± 25.04 mL/ min/1.73 m . Prevalence of mild-to-moderate CKD (stage 3–4) was 44%. Twenty-six percent of patients had severe cognitive impairment, while mild and moderate impairment was found in 7 and 67% of individuals, respectively. All subjects had poor functional and general health status. Cognitive capacities significantly decreased across CKD stages (p for trend < 0.0001). In fully adjusted multivariate analyses, cognitive status remained an independent predictor of eGFR (β = 0.465; p < 0.0001). Conclusions Mild-to-moderate CKD is highly pervasive among frail elderly http://www.deepdyve.com/assets/images/DeepDyve-Logo-lg.png International Urology and Nephrology Springer Journals

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References (32)

Publisher
Springer Journals
Copyright
Copyright © 2018 by Springer Science+Business Media B.V., part of Springer Nature
Subject
Medicine & Public Health; Nephrology; Urology
ISSN
0301-1623
eISSN
1573-2584
DOI
10.1007/s11255-018-1900-3
Publisher site
See Article on Publisher Site

Abstract

Background and aims Cognitive and renal impairment are pervasive among elderly frails, a high-risk, geriatric sub-popula- tion with peculiar clinical characteristics. In a series of frail individuals with non-advanced chronic kidney disease (CKD), we aimed at assessing the entity of functional, general health and cognitive impairment and the possible relationship between these types of dysfunction and the severity of renal impairment. Methods 2229 geriatric subjects were screened for frailty and CKD. Severity of CKD was assessed by eGFR (CKD-EPI formula). Frailty was established by the Fried Index. Functional, general health and cognitive status were assessed by vali- dated score measures. Results Final analysis included 271 frail CKD subjects (162 women, 109 men). Mean eGFR was 64.25 ± 25.04 mL/ min/1.73 m . Prevalence of mild-to-moderate CKD (stage 3–4) was 44%. Twenty-six percent of patients had severe cognitive impairment, while mild and moderate impairment was found in 7 and 67% of individuals, respectively. All subjects had poor functional and general health status. Cognitive capacities significantly decreased across CKD stages (p for trend < 0.0001). In fully adjusted multivariate analyses, cognitive status remained an independent predictor of eGFR (β = 0.465; p < 0.0001). Conclusions Mild-to-moderate CKD is highly pervasive among frail elderly

Journal

International Urology and NephrologySpringer Journals

Published: Jun 4, 2018

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