Related Experiment Video
Updated: Dec 13, 2025
08:50
Assessment of Vascular Function in Patients With Chronic Kidney Disease
Published on: June 16, 2014
16.6K
Self-reported Physical Function Decline and Mortality in Older Adults Receiving Hemodialysis
Rasheeda K Hall1,2,3, Alison Luciano4, Jane F Pendergast4,5
1Durham Veterans Affairs Geriatric Research, Education and Clinical Center, Durham, NC.
Kidney Medicine
|August 1, 2020
Summary
Annual assessment of the 12-Item Short Form Health Survey physical component score (SF-12 PCS) in older dialysis patients showed decline was more common than improvement. This functional decline was not linked to mortality risk factors.
Area of Science:
- Gerontology
- Nephrology
- Health Outcomes Research
Background:
- Early identification of functional decline in elderly dialysis patients is crucial for interventions and care planning.
- The 12-Item Short Form Health Survey physical component score (SF-12 PCS) is a potential tool for tracking functional changes.
Purpose of the Study:
- To evaluate SF-12 PCS changes over one year in older adults on hemodialysis.
- To identify risk factors associated with SF-12 PCS changes.
- To determine the link between SF-12 PCS changes and mortality in this population.
Main Methods:
- Retrospective study of 1,371 adults aged 65+ on hemodialysis for at least 6 months.
- SF-12 PCS measured at least 300 days apart between 2012-2013.
- Multivariable regression and Cox proportional hazards models used for analysis.
Main Results:
- Average SF-12 PCS change was minimal (-0.9 ± 9.6), but 39.3% experienced clinically relevant decline.
- Serum albumin and hemodialysis access type were not associated with SF-12 PCS change.
- SF-12 PCS change did not correlate with mortality risk (aHR, 0.98; 95% CI, 0.96-1.00).
Conclusions:
- In survivors, SF-12 PCS decline was more frequent than improvement over one year.
- Annual SF-12 PCS change was not associated with traditional risk factors or mortality.
- Further research is needed to find optimal methods for assessing functional decline in this group.
Related Concept Videos
01:18Pharmacokinetics in Geriatric Patients: Effect of Age on Drug Excretion
163
In geriatric patients, renal physiology undergoes significant changes, including diminished renal blood flow and a lower glomerular filtration rate (GFR), leading to alterations in medication clearance. Drugs such as aminoglycoside antibiotics, lithium, and digoxin, which rely on glomerular filtration for removal from the body, particularly impact pharmacokinetics. These drugs tend to have slower clearance rates in older adults, necessitating careful dosage considerations.Evaluation of renal...
163
01:25Hemodialysis III: Nursing Management
525
The nursing management of a patient undergoing hemodialysis includes several critical steps, starting with a thorough assessment before the procedure.Before the Hemodialysis ProcedureFirst, record the patient's vital signs—blood pressure, heart rate, respiratory rate, and temperature—to establish a baseline. This baseline is essential for detecting conditions such as hypotension that could impact the patient's response to dialysis. Document the patient's pre-dialysis weight, as this...
525
01:24Hemodialysis II: Procedure and Complications
391
DialyzersA hemodialysis (HD) dialyzer is a plastic cartridge containing thousands of parallel hollow fibers, which serve as semipermeable membranes. These fibers are typically made from cellulose-based or other synthetic materials. During HD, blood is pumped into the top of the cartridge and distributed among these fibers. Simultaneously, dialysis fluid, known as dialysate, is introduced into the bottom of the cartridge, bathing the outside of the fibers. Across the semipermeable membrane,...
391
01:27Dialysis
1.0K
Renal failure occurs when the kidneys lose their ability to filter waste products from the blood effectively. It can be classified into two types: acute renal failure (ARF) and chronic renal failure (CRF).
Acute kidney injury develops suddenly and can be caused by pre-renal causes (e.g., hypovolemia, shock), intrinsic renal causes (e.g., acute tubular necrosis), or post-renal causes (e.g., urinary obstruction). In contrast, chronic renal failure progresses gradually over time and is often...
Acute kidney injury develops suddenly and can be caused by pre-renal causes (e.g., hypovolemia, shock), intrinsic renal causes (e.g., acute tubular necrosis), or post-renal causes (e.g., urinary obstruction). In contrast, chronic renal failure progresses gradually over time and is often...
1.0K
01:15Dialysis
1.4K
Dialysis is a diffusion-based purification process that separates analyte molecules from a complex matrix. This is accomplished by allowing molecules in the solution to pass through a semipermeable membrane into a liquid on the other side. The membrane is usually made of cellulose acetate or cellulose nitrate, and the second liquid must be miscible with the solution. Ions (e.g., chloride or sodium) or organic molecules (e.g., glucose) can pass through the membrane pores, which generally have...
1.4K
01:15Drug Dosing: Geriatric Patients
146
Elderly individuals encompass a diverse population with varying degrees of age-related physiological changes. Defining the elderly presents challenges, as the geriatric population is often arbitrarily categorized as individuals older than 65. However, many individuals in this group lead active and healthy lives, with an increasing number surpassing 85 years and falling into the older elderly category. Physiological changes associated with aging impact performance capacity and homeostatic...
146