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The relevance of ge...
The relevance of geriatric assessments on the association between chronic kidney disease stages and mortality among older people : A secondary analysis of a multicentre cohort study
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- Corsonello, Andrea (författare)
- Karolinska Institutet
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- Soraci, Luca (författare)
- Italian National Research Center on Aging (IRCCS INRCA), Ancona, Fermo and Cosenza, Italy
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- Ärnlöv, Johan, 1970- (författare)
- Högskolan Dalarna,Medicinsk vetenskap,Karolinska Institutet, Stockholm
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- Carlsson, Axel C. (författare)
- Division of Family Medicine and Primary Care, Department of Neurobiology, Care Sciences and Society (NVS), Karolinska Institutet, Stockholm, Sweden; Academic Primary Health Care Centre, Stockholm Region, Stockholm, Sweden
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- Roller-Wirnsberger, Regina (författare)
- Department of Internal Medicine, Medical University of Graz, Austria
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- Wirnsberger, Gerhard (författare)
- Department of Internal Medicine, Medical University of Graz, Austria
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- Mattace-Raso, Francesco (författare)
- Section of Geriatric Medicine, Department of Internal Medicine, Erasmus MC University Medical Center, Rotterdam, The Netherlands
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- Tap, Lisanne (författare)
- Section of Geriatric Medicine, Department of Internal Medicine, Erasmus MC University Medical Center, Rotterdam, The Netherlands
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- Rudholm Feldreich, Tobias (författare)
- Högskolan Dalarna,Medicinsk vetenskap
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- Lattanzio, Fabrizia (författare)
- Italian National Research Center on Aging (IRCCS INRCA), Ancona, Fermo and Cosenza, Italy
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MORENO-GONZALEZ, R (författare)
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KOSTKA, T (författare)
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ARTZI-MEDVEDIK, R (författare)
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MELZER, I (författare)
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SIEBER, C (författare)
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(creator_code:org_t)
- 2022-07-23
- 2022
- Engelska.
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Ingår i: Age and Ageing. - : Oxford University Press. - 0002-0729 .- 1468-2834. ; 51:7
- Relaterad länk:
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https://doi.org/10.1...
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https://du.diva-port... (primary) (Raw object)
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https://urn.kb.se/re...
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https://doi.org/10.1...
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http://kipublication...
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Abstract
Ämnesord
Stäng
- Background: age-adapted definition of chronic kidney disease (CKD) does not take individual risk factors into account. We aimed at investigating whether functional impairments influence CKD stage at which mortality increases among older people. Methods: our series consisted of 2,372 outpatients aged 75 years or more enrolled in a multicentre international prospective cohort study. The study outcome was 24-month mortality. Kidney function was assessed by estimated glomerular filtration rate (eGFR) and albumin-to-creatinine ratio (ACR). Geriatric assessments included handgrip strength, short physical performance battery (SPPB), cognitive impairment, dependency in basic activities of daily living (BADL) and risk of malnutrition. Analysis was carried out by Cox regression, before and after stratification by individual functional impairments. Survival trees including kidney function and functional impairments were also investigated, and their predictivity assessed by C-index. Results: overall, mortality was found to increase starting from eGFR = 30-44.9 ml/min/1.73 m2 (hazard ratio [HR] = 3.28, 95% confidence interval [CI] = 1.81-5.95) to ACR = 30-300 mg/g (HR = 1.96, 95%CI = 1.23-3.10). However, in survival trees, an increased risk of mortality was observed among patients with impaired handgrip and eGFR = 45-59.9 ml/min/1.73 m2, as well as patients with ACR < 30 mg/g and impaired handgrip and SPPB. Survival tree leaf node membership had greater predictive accuracy (C-index = 0.81, 95%CI = 0.78-0.84 for the eGFR survival tree and C-index = 0.77, 95%CI = 0.71-0.81 for the ACR survival tree) in comparison with that of individual measures of kidney function. Conclusions: physical performance helps to identify a proportion of patients at an increased risk of mortality despite a mild-moderate impairment in kidney function and improves predictive accuracy of individual measures of kidney function. © 2022 The Author(s). Published by Oxford University Press on behalf of the British Geriatrics Society. All rights reserved.
Ämnesord
- MEDICIN OCH HÄLSOVETENSKAP -- Klinisk medicin -- Geriatrik (hsv//swe)
- MEDICAL AND HEALTH SCIENCES -- Clinical Medicine -- Geriatrics (hsv//eng)
Nyckelord
- Activities of Daily Living
- Aged
- Albuminuria
- Cohort Studies
- Geriatric Assessment
- Glomerular Filtration Rate
- Hand Strength
- Humans
- Prospective Studies
- Renal Insufficiency
- Chronic
- ADL disability
- albumin to creatinine ratio
- Article
- chronic kidney failure
- cognitive defect
- estimated glomerular filtration rate
- female
- grip strength
- human
- major clinical study
- male
- malnutrition
- mild renal impairment
- moderate renal impairment
- mortality rate
- physical performance
- prognosis
- short physical performance battery
- very elderly
- clinical trial
- cohort analysis
- complication
- daily life activity
- glomerulus filtration rate
- multicenter study
- prospective study
- ACR
- disability
- eGFR
- mortality
- older people
Publikations- och innehållstyp
- ref (ämneskategori)
- art (ämneskategori)
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- Av författaren/redakt...
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Corsonello, Andr ...
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Soraci, Luca
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Ärnlöv, Johan, 1 ...
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Carlsson, Axel C ...
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Roller-Wirnsberg ...
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Wirnsberger, Ger ...
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Mattace-Raso, Fr ...
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Tap, Lisanne
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Rudholm Feldreic ...
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Lattanzio, Fabri ...
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MORENO-GONZALEZ, ...
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KOSTKA, T
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ARTZI-MEDVEDIK, ...
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MELZER, I
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SIEBER, C
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Age and Ageing
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Högskolan Dalarna
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Karolinska Institutet