背景:在接受血液透析的老年人中,虚弱越来越普遍,显著影响认知功能,移动性,和社会参与。这项研究的重点是血液透析中非常年长的成年人的临床特征,特别是检查依赖性和脆弱性的相互作用,以及它们对透析方案的影响。
方法:在这个观察中,描述性研究,对来自四个门诊中心和一个医院的107名75岁以上的患者进行了一年的检查。患者数据包括社会人口统计学因素,透析细节,分析结果,生活方式元素,和自我报告的治疗后疲劳。营养不良-炎症量表用于测量营养状况;MIS量表用于营养不良-炎症,依赖关系的Barthel指数,Charlson合并症指数;虚弱的FRIED量表和SF12生活质量测量。
结果:该研究揭示了大量进行血液透析的老年人面临营养不良(55%),依赖性(21%),脆弱(46%),生活质量下降(57%)。有依赖性的患者明显具有较高的合并症,严重的营养不良,增强的脆弱,疗养院住院医师,依赖救护车运输,和显著有限的流动性,77%的人不能走路。值得注意的是,56%的参与者经历了相当大的透析后疲劳,与较高的合并症相关,依赖性增加,和较差的生活质量。尽管临床条件不同,透析模式在患者队列中一致.
结论:老年人群,平均超过四年的血液透析,表现出很高的合并症,脆弱,和依赖性,需要在运输和生活安排方面提供大量支持。这些患者中有三分之一缺乏残余尿量,然而,他们的透析方案反映了那些保留的输出。这项研究强调了定制治疗策略以减轻依赖性的必要性,保留残余肾功能,缓解透析后的疲劳,最终提高这些患者的身体生活质量。
BACKGROUND: Frailty among older adults undergoing hemodialysis is increasingly prevalent, significantly impacting cognitive function, mobility, and social engagement. This study focuses on the clinical profiles of very older adults in hemodialysis, particularly examining the interplay of
dependency and frailty, and their influence on dialysis regimens.
METHODS: In this observational, descriptive study, 107 patients aged over 75 from four outpatient centers and one hospital unit were examined over a year. Patient data encompassed sociodemographic factors, dialysis specifics, analytical outcomes, lifestyle elements, and self-reported post-treatment fatigue. Malnutrition-inflammation scale was used to measure the Nutritional status; MIS scale for malnutrition-inflammation, Barthel index for
dependency, Charlson comorbidity index; FRIED scale for frailty and the SF12 quality of life measure.
RESULTS: The study unveiled that a substantial number of older adults on hemodialysis faced malnutrition (55%), dependency (21%), frailty (46%), and diminished quality of life (57%). Patients with
dependency were distinctively marked by higher comorbidity, severe malnutrition, enhanced frailty, nursing home residency,
dependency on ambulance transportation, and significantly limited mobility, with 77% unable to walk. Notably, 56% of participants experienced considerable post-dialysis fatigue, correlating with higher comorbidity, increased dependency, and poorer quality of life. Despite varying clinical conditions, dialysis patterns were consistent across the patient cohort.
CONCLUSIONS: The older adult cohort, averaging over four years on hemodialysis, exhibited high rates of comorbidity, frailty, and dependency, necessitating substantial support in transport and living arrangements. A third of these patients lacked residual urine output, yet their dialysis regimen mirrored those with preserved output. The study underscores the imperative for tailored therapeutic strategies to mitigate
dependency, preserve residual renal function, and alleviate post-dialysis fatigue, ultimately enhancing the physical quality of life for these patients.