ABSTRACT
Objective To study the rate of kidney function decline and the influencing factors in the aged population. Methods This was a prospective population-based study of 468 participants aged 65 years and older. All participants’ general health information and serum creatinine levels were collected as the baseline. After a 3-year follow-up ,the serum creatinine level of each participant was measured again.Kidney function was assessed with estimated glomerular filtration rate (eGFR) calculated using the Chronic Kidney Disease-Epidemiology Collaboration ( CKD-EPI ) equation. Outcomes of interest were mean eGFR decline and rapid decline in eGFR (annual eGFR loss≥3 ml·min－1·1.73 m －2).Risk factors were analyzed with Logistic regression. Results At baseline ,the mean age of participants was(78.4 ± 8.7)years and the mean eGFR was(74.8 ± 14.5)ml ·min－1·1.73 m －2.Annual eGFR decline was 1.5 ml·min－1·1.73 m －2,with rapid declines in 149 (32%) participants and stable kidney function in 319 (68%) individuals. The rate of kidney function loss slowed down as the age increased.Baseline eGFR was an independent predictor for rapid kidney function decline. The incidence of rapid kidney function decline in individuals with eGFR ≥ 60 ml· min－1·1.73 m －2was 2.40 times (95% CI :1.16-4.98) higher than that of participants with eGFR＜60 ml·min－1·1.73 m －2after adjustment for confounders. Conclusions Kidney function changes in the community-dwelling elderly in China are heterogeneous. Most elderly individuals do not show appreciable kidney function decline over a 3-year period.
ABSTRACT
With the emerging of aging society and advances of information sciences, telemedicine has gradually become a new medical model.Telemedicine can be used in health monitoring, disease diagnosis, counseling, education, chronic disease management and long-term care in elderly population;particularly in management of chronic heart failure, diabetes and other chronic diseases, as well as in referral and continuous medical care.To promote telemedicine in the elderly population can break the physical limitations of different health care settings, so that geriatrician and the allied team members are enable to maximize their values in providing corresponding health services.This article reviews the progress of telemedicine in foreign countries, which would be of reference value for development of telemedicine for elderly people in China.
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Objective To investigate the differences of four equations to estimate glomerular filtration rate (GFR) and their impacts on chronic kidney disease (CKD) prevalence in communitydwelling elderly people in Beijing.Methods A total of 489 participants aged above 70 years were enrolled.The GFR was estimated using the Cockcroft Gault (CG) equation,Chronic Kidney DiseaseEpidemiology Collaboration (CKD-EPI) equation,Modification of Diet in Renal Disease (MDRD) equation and Berlin Initiative Study (BIS) equation respectively.The internal-consistency check was made on the four equations for the GFR (ml min 1 1.73m 2) estimates.Results The mean age of participants was (81.8±7.6) years.The mean GFR estimated using the CG,CKD-EPI,MDRD and BIS equation was 58.4± 17.2,71.9± 15.3,76.7± 19.1 and 62.7± 12.7,respectively.And the prevalence of CKD was 56.2％,22.7％,17.8％ and 41.7％,respectively.The greatest differences of equations to estimate GFR were seen in elderly people aged 90 and above,and those with body mass index＜ 20.0 kg/m2 or serum creatinine concentration＜ 88.4 μmol/L.Conclusions The GFR estimated using different equations has a large difference which has a significant effect on CKD classification in elderly people.The equation to estimate GFR for the elderly is urgently needed.Until then,the eGFR and CKD classification estimated using different equations should be regarded with caution.
ABSTRACT
Hyponatremia is the most common electrolyte imbalance.Other than neurological complications,other complications of hyponatremia have not received due attention.Mild,chronic hyponatremia can result in subtle symptoms such as gait disturbance and falls,and increase the risks of osteoporosis and fractures.This paper reviewed the emerging relationship between hyponatremia and bone metabolism,its possible mechanisms and clinical implications.