Publication

Functional and Cognitive Impairment, Frailty, and Adverse Health Outcomes in Older Patients Reaching ESRD-A Systematic Review

Kallenberg, M. H., Kleinveld, H. A., Dekker, F. W., van Munster, B. C., Rabelink, T. J., van Buren, M. & Mooijaart, S. P., Sep-2016, In : Clinical Journal of the American Society of Nephrology. 11, 9, p. 1624-1639 16 p.

Research output: Contribution to journalArticleAcademicpeer-review

Copy link to clipboard

Documents

  • Functional and Cognitive Impairment, Frailty, and Adverse Health Outcomes in Older Patients Reaching ESRD—A Systematic Review

    Final publisher's version, 755 KB, PDF document

DOI

  • Marije H. Kallenberg
  • Hilda A. Kleinveld
  • Friedo W. Dekker
  • Barbara C. van Munster
  • Ton J. Rabelink
  • Marjolijn van Buren
  • Simon P. Mooijaart

Background and objectives Older patients reaching ESRD have a higher risk of adverse health outcomes. We aimed to determine the association of functional and cognitive impairment and frailty with adverse health outcomes in patients reaching ESRD. Understanding these associations could ultimately lead to prediction models to guide tailored treatment decisions or preventive interventions.

Design, setting, participants, & measurements We searched MEDLINE, Embase, Web of Science, CENTRAL, CINAHL, PsycINFO, and COCHRANE for original studies published until February 8, 2016 reporting on the association of functional or cognitive impairment or frailty with adverse health outcome after follow-up in patients reaching ESRD either with or without RRT.

Results Of 7451 identified citations, we included 30 articles that reported on 35 associations. Mean age was >60 years old in 73% of the studies, and geriatric conditions were highly prevalent. Twenty-four studies (80%) reported on functional impairment, seven (23%) reported on cognitive impairment, and four (13%) reported on frailty. Mortality was the main outcome measure in 29 studies (97%), and one study assessed functional status trajectory. In 34 of 35 (97%) associations reported, functional or cognitive impairment or frailty was significantly and independently associated with adverse health outcomes. The majority of studies (83%) were conducted in selected patient populations, mainly patients on incident dialysis.

Conclusions Functional and cognitive impairment and frailty in patients reaching ESRD are highly prevalent and strongly and independently associated with adverse health outcomes, and they may, therefore, be useful for risk stratification. More research into their prognostic value is needed.

Original languageEnglish
Pages (from-to)1624-1639
Number of pages16
JournalClinical Journal of the American Society of Nephrology
Volume11
Issue number9
Publication statusPublished - Sep-2016

    Keywords

  • STAGE RENAL-DISEASE, CHRONIC KIDNEY-DISEASE, INCIDENT DIALYSIS PATIENTS, QUALITY-OF-LIFE, COMPREHENSIVE GERIATRIC ASSESSMENT, PATIENTS STARTING DIALYSIS, ELDERLY-PATIENTS, DECISION-MAKING, PERITONEAL-DIALYSIS, MAINTENANCE HEMODIALYSIS

ID: 38592982