tag:blogger.com,1999:blog-4230162007222918868.post6198433224750842746..comments2023-09-19T05:50:03.130-04:00Comments on Renal Fellow Network: Dialysis in the ElderlyGearoid McMahonhttp://www.blogger.com/profile/08049723797363526138noreply@blogger.comBlogger2125tag:blogger.com,1999:blog-4230162007222918868.post-62378598538595470782011-03-27T00:33:49.917-04:002011-03-27T00:33:49.917-04:00Check the full version of the article below. It mi...Check the full version of the article below. It might help guide your response when patients' relatives ask you... 'how long does my dad/ mom have if he/ she stops dialysis?'<br /><br />Journal of the American Geriatrics Society<br />Volume 59, Issue 2, pages 304–308, February 2011<br />End-Stage Renal Disease: A New Trajectory of Functional Decline in the Last Year of Life<br />Fliss E.M. Murtagh PhD, Julia M. Addington-Hall PhD, Irene J. Higginson PhD<br />Article first published online: 28 JAN 2011<br /><br />OBJECTIVES: To determine the functional trajectory in the last year of life in end-stage renal disease managed without dialysis.<br /><br />DESIGN: Longitudinal cohort study of functional status over time and toward death.<br /><br />SETTING: Three renal units in the United Kingdom.<br /><br />PARTICIPANTS: Patients with Stage 5 chronic kidney disease managed conservatively (without dialysis).<br /><br />MEASUREMENTS: The main outcome measure was functional status, measured using the Karnofsky Performance Scale.<br /><br />RESULTS: Seventy-five participants (mean age 80.7, 62% response rate) recruited and followed up monthly for up to 2 years (median 8-month follow-up, range 1–23 months). Forty-nine (66%) died during follow-up. Those who died had similar distribution of age, ethnicity, primary renal pathology, and comorbidity as those still alive at study end. Analysis according to time before death revealed that functional status remained stable during the last year of life but declined steeply in the last month of life.<br /><br />CONCLUSION: This distinctive renal trajectory, reported here for the first time, contrasts with that previously described in other conditions. This has important clinical implications—the steep functional decline indicates that healthcare services need to be rapidly responsive to changing needs in this population as function declines in the last months and weeks of life<br /><br />EDGAR LERMA<br />ChicagoAnonymousnoreply@blogger.comtag:blogger.com,1999:blog-4230162007222918868.post-48497446247492647962009-06-03T12:35:22.417-04:002009-06-03T12:35:22.417-04:00Nice post, and good find from NDT. I will add it t...Nice post, and good find from NDT. I will add it to my talk on geriatric kidney disease before I do it again.Kidney_Boyhttps://www.blogger.com/profile/03706593315253399631noreply@blogger.com