Elderly persons frequently experience acute kidney injury (AKI). Although studies describing its incidence in this population are difficult to compare because definitions of AKI vary dramatically from study to study, it is clear that the elderly are at the very highest risk for developing the condition. Indeed, Feest and coworkers (1) demonstrated that there is a three- to eightfold progressive, age-dependent increase in the frequency of development of community-acquired AKI in patients over 60.
Over the past 25 years, the mean age of patients with AKI has increased by at least five years and perhaps as much as
Chronic kidney disease (CKD) is likely to be the most common condition managed by practicing nephrologists in elderly patients attending a nephrology clinic. Why? Because the majority of individuals with renal disease are 65 or older (Figure 1) and CKD is the most common renal disease in the older individual.
Prevalence of CKD in NHANES 1988–-1994 and 1999–2004 by age group (reprinted from JAMA, 2007)
Although it is a common condition, and each one of us is clearly able to manage CKD, many would argue that CKD should be considered a different disease for
Chronic kidney disease (CKD) is a relatively common condition in the older American population. An estimated 26 million people in the United States are reported to have CKD. As the population of Americans 65 and older grows, so does the incidence of CKD. Evidence now indicates that kidney disease and aging carry a significant risk for cardiovascular complications and sudden death.
The progressive physiological changes with the aging process are inevitable: Aging-associated changes in carbohydrate metabolism and vascular atherosclerosis markedly increase the risk of developing diabetes and hypertension, and these high incidences of comorbid conditions may also lead to a
Hypertension is common in people 60 and older. With increasing age, it is more likely that someone will experience hypertension and die of coronary heart disease even in the prehypertension range (1, 2) (Figure 1). According to the National Health and Nutrition Examination Survey (NHANES) 1999 to 2006, approximately 67 percent of adults in the United States 60 and older had hypertension, a 10 percent increase from NHANES 1988 to 2004 (3). African Americans and women had a higher prevalence of hypertension than did white individuals, and in those 70 and older
U.S. census data show that the population of individuals over 65 in the United States is growing rapidly and is expected to double over the next 20 years. This means that current fellows can expect to see an increasing number of older patients in professional practice. Average life expectancy is currently around 75.2 years for men and 80.4 years for women, and continues to rise. During the 1990s, the fastest growing population was that of individuals over 85, with 38 percent annual growth, and this group is the largest consumer of health care services.
The end stage renal disease (ESRD) end-of-life coalition was developed by a diverse group of individuals committed to patient-centered end-of-life care for ESRD patients, their families, and their health care providers.
Between March 2000 and October 2001, a Robert Wood Johnson Workgroup focusing on end-of-life issues in the ESRD population addressed quality of life, quality of dying, and educational needs, culminating in a published report (1). The Workgroup developed three primary recommendations: 1) Centers for Medicare & Medicaid Services (CMS) should work with the ESRD Networks to coordinate and link dialysis and hospice care; 2) curricula on end-of-life
In the United States, the number of end stage renal disease (ESRD) patients on maintenance dialysis has increased 20 percent in the last decade to 1700 per million, and 100,000 new cases are added every year. The largest increase in both incident and prevalent cases of ESRD has been in individuals ≥65, with rates three- to fourfold higher compared with younger individuals (Figure 1). Nearly 50 percent of all patients on dialysis are ≥65. This increase in the older patient population is likely due to the increasing prevalence of diabetes and hypertension that has contributed to a rise
In the United States, as in many other developed countries, the incidence of treated end stage renal disease (ESRD) increases with advancing age; the highest rates are observed in individuals between the ages of 75 and 79 (Figure 1) (1). There is concern, however, that the functional rehabilitation of elderly dialysis patients is often unsatisfactory and the gain in life expectancy with renal replacement therapy is rather modest. This should not be surprising, because elderly patients with ESRD have a significantly greater burden of coexisting illnesses and are more likely to be frail.
A new calendar year, like a blank page, brings the promise of things to come. ASN Kidney News asked the ASN Board of Advisors and attendees at Renal Week 2010 what things the nephrology community should watch in the coming year. We got answers.
Changes to healthcare administration, especially dialysis services, dominated the responses. The Affordable Healthcare Act, bundling of dialysis payments, and the resurrection of CROWNWeb all raise more questions than answers for our community.
The past year brought a prototype implantable kidney and the first bioengineering session at Renal Week. Technological advances clearly form another “thing
A blog, short for web log, is a user-generated web site. It may serve as a personal diary, an educational tool, a social outlet, or the web presence for a business. Blogs can be text and pictures, but may also include audio or video files. Blogs generally link to other websites such as source materials, and most include a mechanism for comments to generate online discussion. For an excellent example of useful blogs, see Renal Fellow Network (http://renalfellow.blogspot.com/).
What is a wiki?
A wiki is a group-edited document. One person may write an entry,