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老年患者中根据肾小球滤过率划分的老年综合征患病率及共病情况。

Prevalence and co-incidence of geriatric syndromes according to glomerular filtration rate in older patients.

作者信息

Soysal Pinar, Heybeli Cihan, Koc Okudur Saadet, Caliskan Bozyel Emel, Smith Lee, Kazancioglu Rumeyza

机构信息

Division of Geriatric Medicine, Faculty of Medicine, Bezmialem Vakif University, Istanbul, Turkey.

Division of Nephrology, Muş State Hospital, Muş, Turkey.

出版信息

Int Urol Nephrol. 2023 Feb;55(2):469-476. doi: 10.1007/s11255-022-03356-5. Epub 2022 Aug 27.

Abstract

BACKGROUND

Geriatric syndromes are complex clinical manifestations and significant causes of mortality and morbidity. This study was aimed to determine the frequency and co-incidence of geriatric syndromes in older patients with chronic kidney disease (CKD).

METHODS

Older patients were included in this cross-sectional retrospective study. All patients were questioned in terms of geriatric syndromes including dementia, polypharmacy, malnutrition, frailty, probable sarcopenia, urinary incontinence, falls, fear of falling, depression, insomnia, and excessive daytime sleepiness. Geriatric syndromes were evaluated according to Glomerular Filtration Rate (GFR) ≥ 60 ml/min/1.73 m, 30-59 ml/min/1.73 m and < 30 ml/min/1.73 m.

RESULTS

Of the 1320 patients included, the mean age was 79.6 ± 7.8 and 929 (70%) were female. GFR groups ≥ 60 ml/min/1.73 m, 30-59 ml/min/1.73 m, and < 30 ml/min/1.73 m comprised of 55%, 38%, and 7% patients, respectively. The rate of ≥ 3 syndromes in the same person was 66.4% in the group with GFR ≥ 60 ml/min/1.73 m After age and sex adjusted; it was observed that frailty was 2.5 times, probable sarcopenia 2.4 times, and malnutrition 2.7 times more in those with GFR 30-59 ml/min/1.73 m compared to those with GFR ≥ 60 ml/min/1.73 m (p < 0.05). Dementia 1.4, frailty 1.55, polypharmacy 2.0, and urinary incontinence were 1.6 times more common in those with a GFR < 30 ml/min/1.73 m (p < 0.05).

CONCLUSIONS

Each of the geriatric syndromes and their co-incidence are high in older CKD patients. Geriatricians and nephrologists should be aware of geriatric syndromes in older CKD patients, and they should cooperate for the management of these patients.

摘要

背景

老年综合征是复杂的临床表现,也是死亡率和发病率的重要原因。本研究旨在确定老年慢性肾脏病(CKD)患者中老年综合征的发生率和共病情况。

方法

本横断面回顾性研究纳入了老年患者。所有患者均接受了关于老年综合征的询问,包括痴呆、多重用药、营养不良、衰弱、可能的肌肉减少症、尿失禁、跌倒、害怕跌倒、抑郁、失眠和日间过度嗜睡。根据肾小球滤过率(GFR)≥60ml/min/1.73m²、30 - 59ml/min/1.73m²和<30ml/min/1.73m²对老年综合征进行评估。

结果

纳入的1320例患者中,平均年龄为79.6±7.8岁,女性929例(70%)。GFR≥60ml/min/1.73m²、30 - 59ml/min/1.73m²和<30ml/min/1.73m²组的患者分别占55%、38%和7%。在GFR≥60ml/min/1.73m²组中,同一人出现≥3种综合征的比例为66.4%。在调整年龄和性别后,观察到GFR为30 - 59ml/min/1.73m²的患者发生衰弱的可能性是GFR≥60ml/min/1.73m²患者的2.5倍,可能发生肌肉减少症的可能性是2.4倍,营养不良的可能性是2.7倍(p<0.05)。GFR<30ml/min/1.73m²的患者发生痴呆的可能性是1.4倍,衰弱是1.55倍,多重用药是2.0倍,尿失禁是1.6倍(p<0.05)。

结论

老年CKD患者中每种老年综合征及其共病情况都很常见。老年病科医生和肾病科医生应了解老年CKD患者中的老年综合征,并且应合作管理这些患者。

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