Physical and Psychological Burden of Chronic Kidney Disease among Older Adults

McClellan, William M.; Abramson, Jerome L.; Newsome, Britt B.; Temple, Ella M.; Wadley, Virginia G.; Audhya, Paul; McClure, Leslie A.; Howard, Virginia J.; Warnock, David G.; Kimmel, Paul L.

doi:10.1159/000285113

Cited by 54 publications

(36 citation statements)

References 94 publications

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“…The prevalence of patients with CAD, prevalence of patients with DM, prevalence of patients who smoked, prevalence of patients receiving ESA treatment, patients' BMI, and patients' eGFR did not differ between walking and nonwalking patients. These variables were considered as possible confounders because of their association with exercise, mortality, and RRT (17)(18)(19)(20)(21). Walking was associated with lower overall mortality (SHR, 0.65; 95% CI, 0.51 to 0.81; P,0.001) and RRT risk (SHR, 0.75; 95% CI, 0.69 to 0.80; P,0.001).…”

Section: Resultsmentioning

confidence: 99%

Association of Walking with Survival and RRT Among Patients with CKD Stages 3–5

Chen

Wang

Liang

et al. 2014

Clinical Journal of the American Society of Nephrology

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Background and objectives Patients with CKD can benefit from an increase in physical activity. Walking is one of the most common exercises in patients with CKD; however, the association of walking with outcomes in patients with CKD is not clear. This study investigated the association of walking with overall mortality and RRT in patients with CKD stages 3-5.Design, setting, participants, & measurements All patients with CKD stages 3-5 in the CKD program of China Medical University Hospital from June 2003 to May 2013 were enrolled. The risks of overall mortality and RRT were analyzed using competing-risks regressions.Results A total of 6363 patients (average age, 70 years) during a median of 1.3 (range=0.6-2.5) years of follow-up were analyzed. There were 1341 (21.1%) patients who reported walking as their most common form of exercise. The incidence density rate of overall mortality was 2.7 per 100 person-years for walking patients and 5.4 for nonwalking ones. The incidence density rate of RRT was 22 per 100 person-years for walking patients and 32.9 for nonwalking ones. Walking, independent of patients' age, renal function, and comorbidity, was linked to lower overall mortality and lower RRT risk in the multivariate competing-risks regression. The adjusted subdistribution hazard ratio (SHR) of walking was 0.67 (95% confidence interval [95% CI], 0.53 to 0.84; P,0.001) for overall mortality and 0.79 (95% CI, 0.73 to 0.85; P,0.001) for the risk of RRT. The SHRs of overall mortality were 0.83, 0.72, 0.42, and 0.41 for patients walking 1-2, 3-4, 5-6, and $7 times per week, and the SHRs of RRT were 0.81, 0.73, 0.57, and 0.56, respectively.Conclusions Walking is the most popular form of exercise in patients with CKD and is associated with lower risks of overall mortality and RRT. The benefit of walking is independent of patients' age, renal function, and comorbidity.

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Section: Resultsmentioning

confidence: 99%

Association of Walking with Survival and RRT Among Patients with CKD Stages 3–5

Chen

Wang

Liang

et al. 2014

Clinical Journal of the American Society of Nephrology

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“…Whether or not less severe forms of impaired kidney function (30 ml/min/1.73 m 2 or higher) are associated with more depressive symptoms is still largely unknown. Moreover, the largest study that analyzed the continuous relation between eGFR and depressive symptoms found no significant associations [14]. Moreover, we are aware of only two studies on the association between CKD and depressive symptoms in cohorts of cardiac patients.…”

Section: Introductionmentioning

confidence: 99%

“…In three large cross-sectional studies, including 3700 to ≥ 28,000 patients [14–16], those with severe CKD (i.e. with an estimated glomerular filtration rate [eGFR] <30 ml/min/1.73 m 2 ) had more depressive symptoms than those without CKD (eGFR ≥ 60 ml/min/1.73 m 2 ).…”

Section: Introductionmentioning

confidence: 99%

Kidney dysfunction, systemic inflammation and mental well-being in elderly post-myocardial infarction patients

et al. 2017

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BackgroundThe aim was to investigate whether mild kidney dysfunction and low-grade inflammation in post-myocardial infarction patients are independently associated with markers of mental well-being (i.e. depressive and apathy symptoms, and dispositional optimism).MethodsIn post-myocardial infarction patients, kidney function was assessed by estimated glomerular filtration rate (eGFR) calculated from the combined CKD-EPI formula based on serum levels of both creatinine and cystatine C. Systemic inflammation was assessed using high sensitivity C-reactive protein (hs-CRP) levels. The 15-item Geriatric Depression Scale (GDS-15), the 3-item apathy subscale and the 4-item optimism questionnaire (4Q) were used to measure mental well-being and were analyzed using linear multivariable regression analysis.ResultsOf the 2355 patients, mean age was 72.3 (range 63–84) years and 80.1% were men. After multivariable adjustment, a poorer kidney function was associated with more depressive symptoms (β = -0.084, p < 0.001), more apathy symptoms (β = -0.101, p < 0.001), and less dispositional optimism (β = 0.072, p = 0.002). Moreover, higher levels of hs-CRP were associated with more depressive symptoms (β = 0.051, p = 0.013), more apathy symptoms (β = 0.083, p < 0.001) and less dispositional optimism (β = -0.047 p = 0.024). Apathy showed the strongest independent relation with both low eGFR and high hs-CRP.ConclusionsIn post-myocardial infarction patients, impaired kidney function and systemic inflammation showed a stronger association with apathy than with depressive symptoms and dispositional optimism.

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“…[6] In this regard, authors [7][8][9][10][11][12][13][14][15][16][17][18][19][20][21][22] have pointed out that patients on chronic HD experience a multitude of symptoms, both physical and psychological, owing primarily to the trajectory of the kidney disease, to the different treatments received, and to their side effects. In a review of the recent literature on the topic, Almutary et al [8] mentioned that the mean number of symptoms per HD patient ranged from 6 to 20 across studies and that the main symptoms reported by CKD patients, including those on HD, were fatigue or lack of energy (81%), feeling drowsy (75%), pain (65%), pruritus (61%) and dry skin (57%).…”

Section: Introductionmentioning

confidence: 99%

Symptoms and quality of life from patients undergoing hemodialysis in Switzerland

Delmas¹,

Cohen²,

Loiselle

et al. 2017

CNS

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Background: Dialysis patients experience multiple symptoms impairing their quality of life. A relationship seems to exist between the cultural context and the burden of symptoms. In this study, the prevalence and severity of 30 symptoms and their relationship with quality of life among hemodialysis patients in Switzerland is explored. Methods: A cross-sectional correlation design was used with a convenience sample of 119 patients from five dialysis units. Presence and severity of symptoms were assessed with the Dialysis Symptom Index and quality of life with the WHOQOL-Bref questionnaire. Multivariate linear regressions were used to examine the relationship between the prevalence and severity of symptoms, respectively, and quality of life. T-tests and Fisher's tests were used for the international comparisons. Results: On average, patients reported 10 symptoms and often rated these as "somewhat bothersome". The most frequent were: lack of energy, dry skin, trouble falling asleep, trouble staying asleep, and muscle cramps. Average symptoms prevalence and severity levels were both observed to decrease patients' quality of life, items related to physical health and psychological state having the greatest impact. Prevalence and severity of psychological symptoms and prevalence of sex-related symptoms seem to be influenced by patients' cultural context. Conclusions: These results demonstrate that patients on chronic hemodialysis present several symptoms that affect their quality of life. Healthcare professionals should develop strategies to identify more properly these symptoms, especially sex-related and psychological symptoms.

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Physical and Psychological Burden of Chronic Kidney Disease among Older Adults

Cited by 54 publications

References 94 publications

Association of Walking with Survival and RRT Among Patients with CKD Stages 3–5

Association of Walking with Survival and RRT Among Patients with CKD Stages 3–5

Kidney dysfunction, systemic inflammation and mental well-being in elderly post-myocardial infarction patients

Symptoms and quality of life from patients undergoing hemodialysis in Switzerland

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