Frailty in CKD and Transplantation

Lorenz, Elizabeth C.; Kennedy, Cassie C.; Rule, Andrew D.; LeBrasseur, Nathan K.; Kirkland, James L.; Hickson, La Tonya J.

doi:10.1016/j.ekir.2021.05.025

Cited by 55 publications

(42 citation statements)

References 153 publications

(157 reference statements)

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“…Data support the concept of a spiral of frailty, whereby elder patients with CKD are predisposed to inactivity and frailty ( 56 ), and frailty can cause further inactivity and disability ( 57 ). However, while disease and aging contribute to frailty, there are also potentially reversible factors, such as inflammation ( 58 ). Evidence that increased walking improves indicators of inflammation is well-established ( 59 ).…”

Section: Discussionmentioning

confidence: 99%

Daily Step Counts in Patients With Chronic Kidney Disease: A Systematic Review and Meta-Analysis of Observational Studies

et al. 2022

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BackgroundPhysical inactivity is an essential factor in the prognosis of patients with chronic kidney disease (CKD). Daily step count is a straightforward measure to assess physical activity levels. Understanding the step counts among different CKD stages is essential to change sedentary behavior.ObjectivesThis systematic review and meta-analysis aimed to investigate the daily step counts in patients with CKD at a different stage.DesignA systematic review and meta-analysis.Data SourcesThe literature search was performed in PubMed, Embase, and Web of Science from inception to November 3rd, 2021.Review MethodsObservational studies (cross-sectional, case-control, or cohort studies) reported specific values of step counts in CKD patients by the wearable device were included. A random-effects model was used to pool the data. Subgroup analysis explored differences in outcomes by stage of CKD. Heterogeneity between studies was assessed using the χ2 test of Cochrane's Q statistic. A contour-enhanced funnel plot was conducted to investigate publication bias. Univariate and multivariate meta-regression was conducted to examine possible sources of heterogeneity.ResultsTwenty-eight articles were identified and used for quantitative analysis. The result showed that the daily step count in patients with CKD was 4642.47 (95% CI: 4274.18–5010.76), and significantly lower than the healthy population. Subgroup analysis revealed that the step counts decreased before dialysis, dropped to a freezing point at the hemodialysis phase, and increased after kidney transplantation. Meta-regression analysis showed that daily step counts were relatively higher in the Americas or younger than 60 or kidney transplant recipients.ConclusionThe status of daily step counts in patients with CKD decreases with CKD severity and increases after kidney transplantation. Although studies have begun to focus on strategies to improve step counts in patients with CKD, future studies should focus more on step counts in pre-dialysis patients and changing their physically inactive lifestyle early to alleviate deteriorating renal function.Systematic Review Registrationhttps://www.crd.york.ac.uk/prospero/display_record.php?RecordID=291551, identifier: CRD42021291551.

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Section: Discussionmentioning

confidence: 99%

Daily Step Counts in Patients With Chronic Kidney Disease: A Systematic Review and Meta-Analysis of Observational Studies

et al. 2022

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“…For example, dedicated exercise training, comorbidity management, senolytics, etc. may all be potential options for anti-frailty purpose ( 36 ). It would be tempting to pursue these options as adjunct options for counteracting depression in patients with CKD, although more studies are needed in this regard.…”

Section: Discussionmentioning

confidence: 99%

Frailty as an Independent Risk Factor for Depression in Patients With End-Stage Renal Disease: A Cross-Sectional Study

2022

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BackgroundDepression confers substantial disease burden globally, especially among those with chronic kidney disease (CKD). The presence of depression significantly impairs one's quality of life. Risk factors for depression in patients with CKD remain under-appreciated, and whether frailty, a geriatric phenotype, constitutes a risk factor for depression in this population is unknown.MethodsWe prospectively enrolled patients with end-stage renal disease (ESRD) undergoing hemodialysis for >3 months from National Taiwan University Hospital Yunlin Branch between 2019 and 2021. Clinical, physical, functional, and performance parameters were recorded, followed by frailty/sarcopenia assessment. Depression was screened for using the Geriatric Depression Scale. We analyzed the independent relationship between frailty and depression in these patients, using multiple regression analyses.ResultsTotally 151 patients with ESRD were enrolled (mean 61.1 years, 66.9% male), among whom 16.6% had screening-identified depression. ESRD participants with depression did not differ from those without regarding most parameters except serum creatinine, functional indices, and sarcopenia/frailty status. We found that having greater frail severities was independently associated with a higher probability of depression; having FRAIL- (odds ratio [OR] 5.418) and SOF-based (OR 2.858) frailty independently correlated with a higher depression probability. A linear relation exists between a greater frail severity and the probability of depression. Using a more relaxed criterion for detecting depression, higher SOF scores remained significantly associated with an increased depression risk.ConclusionsIn patients with CKD, frailty independently correlated with a higher probability of having depression. Strategies aiming to attenuate frailty may be able to benefit those with depression simultaneously in this population.

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“…Dabei ist es wichtig, die mögliche psychische Belastung der Patient:innen und ihrer Angehörigen zu berücksichtigen, die sich auch aus dem Wissen um die multiplen, organübergreifenden somatischen Folgen, den möglichen Komplikationen, der erforderlichen langfristigen Betreuung und der Furcht vor einer weiteren Verschlechterung der Nierenfunktion ergeben kann [ 20 – 23 ].…”

Section: Folgen Chronischer Nierenerkrankungenunclassified

“…Bei Kindern kann sich eine Wachstumsretardierung belastend auswirken. Familiäre Beziehungen können gefährdet sein [ 19 , 20 , 32 – 39 ]. Die medizinpsychologischen Folgen sind altersspezifisch und müssen im Rahmen der Transition von der Kinder- in die Erwachsenennephrologie und bei der Behandlung älterer Patient:innen Berücksichtigung finden [ 40 – 42 ].…”

Section: Folgen Der Dialysebehandlungunclassified

Langfristige körperliche und psychische Folgen chronischer Nierenerkrankungen

Thaiss

2022

Bundesgesundheitsbl

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ZusammenfassungAufgrund der verbesserten Behandlungsoptionen können Patient:innen mit chronischen Nierenerkrankungen heute deutlich länger überleben als noch vor 10 Jahren. Das Überleben ist für die Betroffenen jedoch immer mit einem Verlust an Lebensqualität verbunden. In diesem Beitrag wird eine kurze Übersicht über die körperlichen und psychischen Erkrankungsfolgen, Begleiterkrankungen und Therapienebenwirkungen bei chronischen Nierenerkrankungen gegeben. Auf bisher bekannte Auswirkungen der COVID-19-Pandemie wird hingewiesen. Abschließend wird aufgezeigt, wie die Langzeitbehandlung weiterentwickelt werden sollte, um die Lebensqualität der Patient:innen zu erhöhen.Funktionseinschränkungen der Niere haben aufgrund der Kontamination des Blutes mit harnpflichtigen Substanzen (Urämie) schwere Auswirkungen auf den Gesamtorganismus. Zusätzlich sind die Patient:innen von Nebenwirkungen betroffen, die im Zusammenhang mit der medikamentösen Therapie, Dialyse oder Nierentransplantation auftreten können. Patient:innen und Angehörige sind einer großen psychischen Belastung ausgesetzt. Infektionen mit SARS-CoV‑2 können die Nierenfunktion beeinträchtigen und auch die Prognose einer bereits bestehenden Erkrankung verschlechtern.Die ganzheitliche Versorgung der Patient:innen mit chronischen Nierenerkrankungen muss neben der medizinischen Versorgung auch die psychologischen und psychosozialen Aspekte berücksichtigen. Nephrologie und Psychonephrologie müssen Hand in Hand weiterentwickelt werden, um die medizinische Versorgung und Lebensqualität der betroffenen Patient:innen zu verbessern.

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Frailty in CKD and Transplantation

Cited by 55 publications

References 153 publications

Daily Step Counts in Patients With Chronic Kidney Disease: A Systematic Review and Meta-Analysis of Observational Studies

Daily Step Counts in Patients With Chronic Kidney Disease: A Systematic Review and Meta-Analysis of Observational Studies

Frailty as an Independent Risk Factor for Depression in Patients With End-Stage Renal Disease: A Cross-Sectional Study

Langfristige körperliche und psychische Folgen chronischer Nierenerkrankungen

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