Publication: La fragilidad en el paciente anciano con enfermedad renal crónica avanzada
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2021-07-13
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Universidad Complutense de Madrid
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Abstract
En los últimos años el concepto de fragilidad como «estado de pre-discapacidad» se ha extendido de forma amplia en todos los que trabajamos en beneficio de la persona mayor. Su importancia radica no solo en su elevada prevalencia, superior al 25% en mayores de 85 años, sino a que es considerada un sindrome geriátrico capaz de identificar aquella población en riesgo de presentar sucesos adversos graves de salud que se relacionan con el envejecimiento no exitoso y con el deterioro en la calidad de vida del individuo. El estudio de la función renal es relevante en pacientes que soportan gran carga de comorbilidad, habiéndose encontrado una importante asociación entre la enfermedad renal crónica y el desarrollo de eventos clínicos adversos como la enfermedad cardiovascular, la insuficiencia cardiaca, la enfermedad renal terminal, el incremento de la susceptibilidad a infecciones y el mayor deterioro funcional y cognitivo. Entre los pacientes con enfermedad renal crónica, los adultos mayores en el estadio avanzado de la enfermedad, constituyen la población con mayor dificultad en el manejo, especialmente al plantear el inicio de la terapia renal sustitutiva (TRS), debido a su mayor comorbilidad y a la menor expectativa de vida respecto a otros grupos de pacientes. Dado que la fragilidad puede ser una condición reversible, su estudio en el paciente con enfermedad renal crónica avanzada es de especial interés. OBJETIVOS: Objetivo principal: Determinar la capacidad predictiva de la condición de fragilidad –según los criterios de Fried- en la evolución del anciano con ERCA (mortalidad, ingreso hospitalario, inicio de TRS)...
In recent years, the concept of frailty as a “state of pre-disability” has been widely accepted by those involved in elderly care. Its importance, lies not only in its high prevalence rate, more common in 25% of the population 85 years of age or older. It is considered a geriatric syndrome, capable of identifying people at risk of serious adverse health outcomes related with unsuccessful ageing and with detrimental of quality of life. The study of renal function is relevant in patients with major comorbidities. Studies have shown a significant association between chronic kidney disease and the development of adverse clinical outcomes such as heart disease, heart failure, end-stage renal disease, increased susceptibility to infections, and greater functional and cognitive impairment. When considering renal replacement therapy (RRT), compared with patients in other age groups, due to the high comorbidity rate and lower life expectancy, elderly patients among the advanced stages of chronic kidney disease make up a population with the greatest difficulty in management. However, older people can reverse frailty and improve functionality. Therefore, the study o frailty in patients with chronic kidney disease is of particular interest. OBJECTIVES: Main Objective: To determine the predictive ability of frailty condition –according to Fried's criteria- to predict risk for the onset of adverse outcomes in older patients with ACKD (mortality, hospital admission, onset of RRT)...
In recent years, the concept of frailty as a “state of pre-disability” has been widely accepted by those involved in elderly care. Its importance, lies not only in its high prevalence rate, more common in 25% of the population 85 years of age or older. It is considered a geriatric syndrome, capable of identifying people at risk of serious adverse health outcomes related with unsuccessful ageing and with detrimental of quality of life. The study of renal function is relevant in patients with major comorbidities. Studies have shown a significant association between chronic kidney disease and the development of adverse clinical outcomes such as heart disease, heart failure, end-stage renal disease, increased susceptibility to infections, and greater functional and cognitive impairment. When considering renal replacement therapy (RRT), compared with patients in other age groups, due to the high comorbidity rate and lower life expectancy, elderly patients among the advanced stages of chronic kidney disease make up a population with the greatest difficulty in management. However, older people can reverse frailty and improve functionality. Therefore, the study o frailty in patients with chronic kidney disease is of particular interest. OBJECTIVES: Main Objective: To determine the predictive ability of frailty condition –according to Fried's criteria- to predict risk for the onset of adverse outcomes in older patients with ACKD (mortality, hospital admission, onset of RRT)...
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Tesis inédita de la Universidad Complutense de Madrid, Facultad de Medicina, Departamento de Medicina, leída el 21/01/2021