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Risk factors and consequences of decreased kidney function in nursing home residents : A longitudinal study

Bolmsjö, Beata Borgström LU ; Mölstad, Sigvard LU ; Gallagher, Martin; Chalmers, John; Östgren, Carl Johan LU and Midlöv, Patrik LU (2016) In Geriatrics & Gerontology International
Abstract

Aim: The aim of the present study was to study the renal function and the relationship of deterioration in renal function with major outcomes in elderly nursing home residents. A second aim was to compare the internationally recommended formulae for estimated glomerular filtration rate (eGFR) consisting of both creatinine and cystatinC in a nursing home population. Methods: A total of 429 patients from 11 nursing homes were included during 2008-2011. GFR was estimated, from formulae based on both creatinine and cystatinC, at baseline and after 1 and 2years. The patients were divided into groups based on chronic kidney disease level, and comparisons were made for mortality, morbidity, the use of medications and between the different... (More)

Aim: The aim of the present study was to study the renal function and the relationship of deterioration in renal function with major outcomes in elderly nursing home residents. A second aim was to compare the internationally recommended formulae for estimated glomerular filtration rate (eGFR) consisting of both creatinine and cystatinC in a nursing home population. Methods: A total of 429 patients from 11 nursing homes were included during 2008-2011. GFR was estimated, from formulae based on both creatinine and cystatinC, at baseline and after 1 and 2years. The patients were divided into groups based on chronic kidney disease level, and comparisons were made for mortality, morbidity, the use of medications and between the different formulae for eGFR. Results: Survival was lower in the groups with lower renal function. Over 60% of the residents had impaired renal function. Those with impaired renal function were older, had a higher number of medications and a higher prevalence of heart failure. Higher number of medications was associated with a greater risk of rapid decline in renal function with an odds ratio of 1.2 (95% confidence interval 1.06-1.36, P=0.003). The compared eGFR formulae based on both cystatinC and creatinine were in excellent concordance with each other. Conclusions: Decreased renal function was associated with increased mortality. A majority of nursing home residents had declining renal function, which should be considered when prescribing medications. The more medications, the higher the risk for rapidly declining renal function.

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author
organization
publishing date
type
Contribution to journal
publication status
in press
subject
keywords
Clinical medicine, Geriatric medicine, Kidney, Urinary tract
in
Geriatrics & Gerontology International
publisher
Wiley-Blackwell
external identifiers
  • Scopus:84966373393
ISSN
1444-1586
DOI
10.1111/ggi.12789
language
English
LU publication?
yes
id
92541a57-4a4d-4532-ba6e-6a4b07aea1a2
date added to LUP
2016-06-01 11:08:47
date last changed
2016-11-21 08:00:39
@misc{92541a57-4a4d-4532-ba6e-6a4b07aea1a2,
  abstract     = {<p>Aim: The aim of the present study was to study the renal function and the relationship of deterioration in renal function with major outcomes in elderly nursing home residents. A second aim was to compare the internationally recommended formulae for estimated glomerular filtration rate (eGFR) consisting of both creatinine and cystatinC in a nursing home population. Methods: A total of 429 patients from 11 nursing homes were included during 2008-2011. GFR was estimated, from formulae based on both creatinine and cystatinC, at baseline and after 1 and 2years. The patients were divided into groups based on chronic kidney disease level, and comparisons were made for mortality, morbidity, the use of medications and between the different formulae for eGFR. Results: Survival was lower in the groups with lower renal function. Over 60% of the residents had impaired renal function. Those with impaired renal function were older, had a higher number of medications and a higher prevalence of heart failure. Higher number of medications was associated with a greater risk of rapid decline in renal function with an odds ratio of 1.2 (95% confidence interval 1.06-1.36, P=0.003). The compared eGFR formulae based on both cystatinC and creatinine were in excellent concordance with each other. Conclusions: Decreased renal function was associated with increased mortality. A majority of nursing home residents had declining renal function, which should be considered when prescribing medications. The more medications, the higher the risk for rapidly declining renal function.</p>},
  author       = {Bolmsjö, Beata Borgström and Mölstad, Sigvard and Gallagher, Martin and Chalmers, John and Östgren, Carl Johan and Midlöv, Patrik},
  issn         = {1444-1586},
  keyword      = {Clinical medicine,Geriatric medicine,Kidney,Urinary tract},
  language     = {eng},
  publisher    = {ARRAY(0xbb820f0)},
  series       = {Geriatrics & Gerontology International},
  title        = {Risk factors and consequences of decreased kidney function in nursing home residents : A longitudinal study},
  url          = {http://dx.doi.org/10.1111/ggi.12789},
  year         = {2016},
}