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Updated: Jun 27, 2025

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Geriatric Assessment in CKD Care: An Implementation Study.

Carlijn G N Voorend1, Noeleen C Berkhout-Byrne1, Leti van Bodegom-Vos2

  • 1Department of Internal Medicine (Nephrology), Leiden University Medical Center, Leiden, The Netherlands.

Kidney Medicine
|April 25, 2024
PubMed
Summary
This summary is machine-generated.

Geriatric assessment was successfully integrated into chronic kidney disease (CKD) care for older adults. Healthcare professionals found the assessment relevant, despite barriers like time constraints and patient burden.

Keywords:
Chronic kidney diseasefeasibility studiesgeriatric assessmentimplementation scienceolder peopleshared decision making

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Area of Science:

  • Geriatric Medicine
  • Nephrology
  • Implementation Science

Background:

  • Older adults with progressive chronic kidney disease (CKD) have complex needs.
  • Guidelines recommend geriatric evaluation before kidney replacement decisions, but it's rarely implemented.
  • Lack of routine geriatric assessment hinders optimal care for elderly CKD patients.

Purpose of the Study:

  • To evaluate the implementation of a geriatric assessment tailored for CKD care.
  • To assess the feasibility and perceived relevance of geriatric assessment in routine nephrology practice.
  • To identify enablers and barriers to integrating geriatric assessment into CKD patient management.

Main Methods:

  • A mixed-methods implementation study was conducted in Dutch nephrology centers.
  • A consensus-based, nephrology-tailored geriatric assessment was implemented for patients aged ≥70 years with eGFR ≤20 mL/min/1.73 m².
  • Implementation was evaluated via surveys on perceived enablers, barriers, work routine integration, and instrument relevance.

Main Results:

  • Geriatric assessment was implemented in 10 centers, reaching 191 patients.
  • Multidisciplinary collaboration and nurse-led assessments facilitated implementation.
  • Barriers included patient illiteracy, language barriers, time constraints, and patient burden.
  • Professionals rated integration into work routines (6.7/10) and relevance (7.8/10) favorably.
  • The Clinical Frailty Score and Montreal Cognitive Assessment were deemed most relevant.

Conclusions:

  • Geriatric assessment can be successfully integrated into the care of older adults with CKD.
  • The implemented assessment was perceived as relevant by healthcare professionals.
  • Addressing identified barriers is crucial for broader and more effective implementation.