Rehabilitation in CKD
October 22, 2020 | 10:00 AM - 12:00 PM
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Rehabilitation in CKD
- Advances in Geriatric Nephrology
October 22, 2020 | Location: On-Demand
Abstract Time: 10:00 AM - 12:00 PM
Category: Geriatric Nephrology
- 1100 Geriatric Nephrology
- Grupp, Clemens, Academic Teaching Hospital Bamberg, Bamberg, Germany
- Tuemena, Thomas, GiB-DAT Head Office, Nuernberg, Germany
- Troegner, Jens, Academic Teaching Hospital St. Marien, Amberg, Germany
- Swoboda, Walter, Klinikum Main-Spessart, Marktheidenfed, Germany
- Gassmann, Karl-Guenter, Waldkrankenhaus St. Marien, Erlangen, Germany
Older patients with impaired renal function (renal patients: RP) often show the criteria of a geriatric patient with increasing stages of CKD. Geriatric phenomena such as frailty are considered a predictor of poor outcomes particularly during acute illness in these patients. These consequences can be alleviated in patients without renal insufficiency (HP) by rehabilitative measures both in acute geriatrics units (AG) and in inpatient geriatric rehabilitation facilities (RG). So far it is largely unknown whether RP benefit from this type of rehabilitation to the same extent as HP. We have now examined this question by evaluating a large geriatric database.
The Geriatrics in Bavaria-Database (GiB-DAT) was established with the support of the Ministry of Health as a quality assurance project. It comprises the vast majority of anonymized records of cases treated in Bavarian AG and RG. In this study all data records for the years 2012-2019 from AG and RG were evaluated. The following parameters were examined: At admission: age, gender, cognition (Minimal Status Examination: MMSE), emotion (Geriatric Depression Scale: GDS), degree of care (DC); at discharge: number of diagnoses and medication; at admission and discharge: self-help ability (Barthel Score: BS), mobility (Timed Up and Go-Test: TUG) and place of residence.
Both in AG and RG, HP (AG/RG n=116513/248831) and RP (AG/RG n=27294/45984) did not relevantly differ in age, gender, MMSE, GDS and DC. The number of diagnoses (AG: 10.7 vs. 9.3; RG 10.3 vs. 8.3) and drugs (AG 10.1 vs. 9.3; RG 9.9 vs. 9.0) was slightly higher in RP compared to HP. No major differences between RP and HP were observed at the beginning of the rehabilitation in BS, TUG and place of residence. In RP/HP, BS improved during rehabilitation by +14.4/14.5 (AG) and +21.1/21.9 (RG) points and the number of patients "able to walk" in the TUG by +22.1/20.6% (AG) and +14.3/14.5% (RG) respectively. Domestic living could be maintained in 66.0/68.9% (AG) and 81.6/81.5% (RG). Subgroup analysis of CKD-stages 3-5 showed no relevant difference for any of the examined parameters both in AG and RG.
RP benefit to a similar extent as HP from rehabilitative measures both in AG and RG with respect to improvement of self-help ability, mobility as well as the preservation of private residency.This was observed regardless of the stage of renal insufficiency.