Preventing acute kidney injury in high-risk patients by temporarily discontinuing medication – an observational study in general practice

Faber, Suzanne J.; Scherpbier, Nynke; Peters, H.F.M.; Uijen, Annemarie

doi:10.1186/s12882-019-1636-z

Cited by 21 publications

(22 citation statements)

References 13 publications

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“…during periods of vomiting and/or diarrhoea). 46 Less anticipated complaints were injuries (13%), skin (12%) and musculoskeletal complaints (2%). Especially falling deserves further investigation, as falls are a major determinant of morbidity and mortality in older adults.…”

Section: Discussionmentioning

confidence: 98%

Predicting morbidity in older travellers during a short-term stay in the tropics: the ELDEST study

Vlot

Vive

Brockhoff

et al. 2020

Journal of Travel Medicine

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Background: Older persons may suffer more from travel-related health problems because of aging and underlying chronic disorders. Knowledge on who is more likely to have these health problems helps to tailor travel health advice more specifically. This study aimed to determine predictors of travel-related morbidity in older travelers by assessing their pre-travel characteristics and performance using physical and cognitive functioning tests. Methods: Multicenter prospective cohort study among older travelers (≥60 years) who consulted one of the participating Dutch travel clinics. Handgrip strength and cognitive performance were measured pre-travel. Participants completed questionnaires before departure and one and four weeks after return. A diary recorded health complaints during travel until two weeks post-travel. Results: 477 travelers completed the study (follow-up rate of 97%). Participants’ median age was 66 years. The most visited regions were South-East Asia (34%) and South Asia (14%). Median travel duration was 19 days. Polypharmacy (≥5 medications per day) was not uncommon (16%). The median Charlson Comorbidity Index (CCI) score was 0. Self-reported travel-related infectious diseases concerned primarily respiratory tract infections (21%) and gastroenteritis (10%), while non-infectious complaints were injuries (13%), peripheral edema (12%), and dehydration (3%). Medical assistance was sought by 18%, mostly post-travel from their general practitioner (87%). Self-reported physical and mental health-related quality of life significantly improved during and after travel. Predictors for an increased risk of travel-related morbidity were higher CCI score, more travel experience, longer travel duration, higher number of daily medications, visiting northern Africa or South-East and East Asia, and phone- and social media use. Conclusions: Older Dutch travelers are generally fit, well-prepared and suffer not only from common infectious health problems, but also from injuries. Travel improved their self-perceived health. The predictors could be used to identify the more at-risk older traveler and to decrease travel-related morbidity by optimizing pre-travel advice.

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Section: Discussionmentioning

confidence: 98%

Predicting morbidity in older travellers during a short-term stay in the tropics: the ELDEST study

Vlot

Vive

Brockhoff

et al. 2020

Journal of Travel Medicine

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“…Infections and hypertension were the principal causes for hospital acquired AKI in another African cohort 27 . Elderly patients with underlying chronic kidney disease (CKD) or heart failure are at increased risk for developing AKI when using non-steroidal-anti-inflammatory drugs (NSAIDs), diuretics, and renin-angiotensin-aldosterone-system (RAAS) inhibitors during periods of fluid loss 28,22 . Dialysis requiring AKI represents another major health burden.…”

Section: Discussionmentioning

confidence: 99%

Characteristics, risk factors and outcomes of community-acquired acute kidney injury in the elderly: a prospective tertiary hospital study, Egypt

Shemiesa¹,

Abdelsalam²,

Elnagara³

et al. 2022

Afr H. Sci.

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Background: Acute Kidney Injury (AKI) is a public health problem. Elderly present a greater predisposition to the development of AKI, either due to kidney senility, or due to high prevalence of comorbidities and polypharmacy. Considering the scarcity of studies on AKI in the elderly particularly in developing countries, this study emphasizes on the pattern and outcome of AKI in the Egyptian elderly. Objective: To analyze the demographics, risk factors and outcomes of Acute Kidney Injury (AKI) in the Egyptian elderly. Methods: A total of 199 patients were included over one year and were divided into two groups; group I (79 elderly patients) and group II (120 non-elderly patients). The two groups were compared regarding demographics, risk factors and major outcomes including patient and renal survival. Results: Elderly patients showed a higher prevalence of Diabetes Mellitus and chronic kidney disease (p=0.004 and 0.005 respectively). Pre-renal causes of AKI principally dehydration represented the major risk factor (p=0.003). Sepsis and hypertension predicted mortality in the elderly (p=0.001 and 0.035 respectively). Conclusion: In our locality; the elderly is highly vulnerable to AKI. Pre-renal causes principally dehydration represent the main triggers of AKI. Sepsis and hypertension contribute to mortality in this population. Preventive strategies are crucial not only in the hospital but also at home. Keywords: Chronic Kidney Disease; Community Acquired Acute Kidney Injury; Dehydration; Elderly; Hypertension.

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“…Within an episode of care, all diagnostic actions and interventions are registered, including history, physical examination, diagnostic tests, medical advice, referrals, and medical correspondence from hospitals. 20 Furthermore, for each consultation, GPs register a reason for encounter (RFE). The RFE is defined as the first complaint, symptom, or request the patient mentions when consulting the GP.…”

Section: Design and Settingmentioning

confidence: 99%

Exploring diagnostic strategies for memory complaints in older adults: A retrospective general practice database study

Linden,

Perry,

Wolfs

et al. 2024

Int J Geriat Psychiatry

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ObjectivesFor older people who worry about their memory, their general practitioner (GP) is often the first healthcare professional they turn to. This study aims to increase knowledge of GPs' daily practice on diagnostic strategies for patients who present themselves with memory complaints and/or worries about dementia for the first time in general practice and to explore associations of patients' characteristics with these strategies.MethodRetrospective observational study using electronic patient records from patients presenting with memory complaints between 2012 and 2019. The patient records are derived from a Dutch primary care registration network. The decision on diagnostic strategy was extracted and categorized as (1) wait and see, (2) diagnostic testing in primary care, or (3) referral. Patient characteristics (gender, age, general practice, level of comorbidities, chronic polypharmacy, and the number of consultations on memory complaints), fear of developing dementia, and information on why the first consultation on memory complaints was scheduled were extracted.ResultsA total of 228 patients were included. Most patients were cared for within primary care, either for further primary care diagnostics (56.1%) or because a wait‐and‐see strategy was pursued (14.9%). One‐third (28.9%) of patients were referred. Differences between diagnostic strategies in patient characteristics, fear of developing dementia, or reason for first consultation between these diagnostic strategies were not found, nor were these variables predictive of referral.ConclusionMost Dutch patients with memory complaints and/or worries about dementia who seek help from their GP for the first time are cared for in the primary care setting for the following 6 months. The lack of association between included patient characteristics and diagnostic strategies highlights the complexity of the decision‐making process on diagnostic testing for dementia in general practice.

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Preventing acute kidney injury in high-risk patients by temporarily discontinuing medication – an observational study in general practice

Cited by 21 publications

References 13 publications

Predicting morbidity in older travellers during a short-term stay in the tropics: the ELDEST study

Predicting morbidity in older travellers during a short-term stay in the tropics: the ELDEST study

Characteristics, risk factors and outcomes of community-acquired acute kidney injury in the elderly: a prospective tertiary hospital study, Egypt

Exploring diagnostic strategies for memory complaints in older adults: A retrospective general practice database study

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