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In patients with renal impairment, drugs undergo significant changes in their pharmacokinetics, which require dosage adjustments to ensure safe and effective therapy.
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Chronic Kidney Disease (CKD) progressively impairs multiple body systems due to the accumulation of uremic toxins, which disrupt cellular functions across various organs.Neurologic symptomsNeurologic symptoms often arise early in CKD, as uremic toxin buildup drives changes in cognitive and motor functions. Patients frequently experience fatigue, headache, confusion, difficulty concentrating, and, in severe cases, seizures. Peripheral neuropathy commonly manifests as burning sensations in the...
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[Frailty in renal diseases].

Lena Schulte-Kemna1, Miriam Künzig2, Dhayana Dallmeier3,4

  • 1Klinik für Innere Medizin I, Sektion Nephrologie, Universitätsklinikum Ulm, Albert-Einstein-Allee 23, 89081, Ulm, Deutschland. Lena.Schulte-Kemna@uniklinik-ulm.de.

Zeitschrift Fur Gerontologie Und Geriatrie
|August 5, 2021
PubMed
Summary

Frailty, a syndrome of reduced resistance to stress, is more common in chronic kidney disease (CKD) patients, leading to poorer outcomes. Early, interdisciplinary evaluation is key for managing frail CKD patients.

Keywords:
DialysisFrailtyGeriatric medicineInfirmityKidney

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Area of Science:

  • Geriatrics
  • Nephrology
  • Public Health

Background:

  • Frailty is a syndrome of reduced resistance to stress due to age-related degeneration, linked to adverse outcomes like falls, hospitalization, and mortality in the general population.
  • Frailty is more prevalent and occurs earlier in patients with chronic kidney disease (CKD), regardless of dialysis status, leading to reduced quality of life and increased mortality.
  • Identifying frailty in CKD patients can reveal modifiable risk factors, highlighting the need for timely intervention.

Purpose of the Study:

  • To highlight the increased prevalence and impact of frailty in patients with chronic kidney disease (CKD).
  • To emphasize the importance of early identification and interdisciplinary management of frail CKD patients.
  • To propose a multidimensional, interdisciplinary approach for managing frailty in CKD patients across different clinical settings.

Main Methods:

  • Review of existing literature on frailty and its association with chronic kidney disease.
  • Discussion of the implications of frailty in CKD patients regarding clinical outcomes and quality of life.
  • Proposal of an interdisciplinary, multidimensional evaluation strategy for early identification and management.

Main Results:

  • Frailty significantly increases the risk of poor outcomes in CKD patients, including hospitalization and mortality.
  • Early nephrological evaluation and an interdisciplinary approach are crucial for preventing and managing frailty in CKD.
  • While several frailty assessment tools exist, specific recommendations for nephrology are lacking.

Conclusions:

  • Frailty is a critical concern in chronic kidney disease (CKD) management, necessitating proactive identification and intervention.
  • An interdisciplinary, multidimensional approach is recommended for the early detection and management of frail CKD patients.
  • Consistent identification and follow-up of frail CKD patients are paramount, irrespective of the specific assessment method used.