MO430: Octogenarians Referred to the Nephrologist: Evolution and Progression Risk Factors

Abstract

BACKGROUND AND AIMS The actual definition of chronic kidney disease (CKD) applied to patients ˃80 years has generated an increase in the number of referrals to Nephrology for consultation. Nowadays there is a debate about the evolution of kidney function in elderly patients, from physiological evolution of kidney function to identifying which factors are associated with a real progression of CKD. The aim of this study is to analyse the evolution of kidney function in patients ˃80 years referred to Nephrology for consultation for the first time. METHOD A single-centre retrospective study in which we included patients ˃80 years with an estimated glomerular filtration rate (eGFR) <60 mL/min/1,73m2 who were referred to Nephrology consultation from 2015 to 2018. We collected clinical and analytical parameters at the following points in time: 12 months before the visit, baseline and 12 months after the initial visit. We divided patients into two groups based on annual eGFR loss: Group 1 progressors (>5 mL/min/1.73m2) and group 2 non-progressors (≤5 mL/min/1.73m2). RESULTS A total of 348 patients were included in the study, 55.2% were women and the mean age was 84 years (80–97). At the time of first medical visit, the mean creatinine value was 1.6 ± 0.6 mg/dL, median eGRF was 38 mL/min/1.73m2 (29–44) and median albumin/creatinine ratio was 55 mg/g (6–419), with 12% of the patients, presenting albuminuria over 1000 mg/g. The most frequent referral criteria were worsening of renal function (85.6%). Comorbidities were very common, and hypertension, dyslipidaemia and diabetes mellitus were present in 89.4%, 42.8% and 42.2% respectively. A total of 51% of the patients met the definition of progressor at baseline (initial-progressors) and 29.4% were progressors after a 12-month follow-up. Interestingly, only 21.6% of initial-progressors kept meeting this definition 12 months after (Figure 1). The main risk factors for progression were a higher baseline eGFR (P < 0.001) and albuminuria (P < 0.002). No association with comorbidities was found in the multivariate analysis. CONCLUSION The majority of patients ˃80 years evaluated by a Nephrologist were non-progressors at 12 months according to our definition (70.6%). It is more important to estimate the progression of CKD patients and request albuminuria and/or proteinuria than an isolated GFR value. It is likely that non-progressors do not need to be followed by a Nephrologist and may remain under primary care control.

Análisis del protocolo de curl nórdico de isquiotibiales en la flexibilidad de los deportistas (Analysis of the Nordic curl protocol in the flexibility of athletes)

“…En cuanto a la viabilidad del proyecto, presentó una alta tasa de participación, adherencia, tolerabilidad y seguridad para los deportistas. Siendo un indicador de que este protocolo es aplicable a todas las disciplinas deportivas, que no representa un alto coste, es de fácil ejecución y genera ciertos beneficios tanto a nivel muscular, disminución del riesgo de lesión y mejoras en fuerza, sprint y cambios de dirección (Rico-González & Morales-Hernández, 2021).…”