ASN's Mission

ASN leads the fight to prevent, treat, and cure kidney diseases throughout the world by educating health professionals and scientists, advancing research and innovation, communicating new knowledge, and advocating for the highest quality care for patients.

learn more

Contact ASN

1401 H St, NW, Ste 900, Washington, DC 20005

email@asn-online.org

202-640-4660

The Latest on Twitter

Kidney Week

Abstract: PO1689

Rehabilitation in CKD

Session Information

Category: Geriatric Nephrology

  • 1100 Geriatric Nephrology

Authors

  • 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
Background

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.

Methods

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.

Results

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.

Conclusion

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.