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Abstract: PO1686

Design of a Consensus-Based Geriatric Assessment Tailored for Older Patients Approaching ESKD

Session Information

Category: Geriatric Nephrology

  • 1100 Geriatric Nephrology

Authors

  • Voorend, Carlijn G N, Leids Universitair Medisch Centrum, Leiden, Zuid-Holland, Netherlands
  • Berkhout-Byrne, Noeleen C., Leids Universitair Medisch Centrum, Leiden, Zuid-Holland, Netherlands
  • Diepenbroek, Adry, Universitair Medisch Centrum Groningen, Groningen, Groningen, Netherlands
  • Franssen, Casper F.M., Universitair Medisch Centrum Groningen, Groningen, Groningen, Netherlands
  • Bos, Willem Jan W., Leids Universitair Medisch Centrum, Leiden, Netherlands
  • Mooijaart, Simon, Leids Universitair Medisch Centrum, Leiden, Zuid-Holland, Netherlands
  • Van Buren, Marjolyn, Leids Universitair Medisch Centrum, Leiden, Zuid-Holland, Netherlands

Group or Team Name

  • on behalf of principal investigators of the POLDER study
Background

Routine geriatric evaluation in older patients approaching end stage kidney disease (ESKD), benefits disclosure of highly prevalent unidentified functional and cognitive impairments. Although recommended in guidelines, a suitable standardized geriatric test set is lacking. We aim to propose a consensus-based test set for geriatric assessment useful in both routine care and research in older (≥ 65 year) patients approaching ESKD.

Methods

A multidisciplinary expert panel of physicians, nurses and supportive disciplines with clinical and/or scientific experience in geriatric nephrology was assembled. Preconditions and selection-criteria for the selection of potential measures resulted from general geriatric principles, critical appraisal of literature, inventory of conventional instruments, and focus group meetings with patients, carers and health professionals. Older patients (aged ≥65 years) approaching end-stage kidney disease (eGFR < 20 ml/min/1.73M2) were selected as the target population. An expert panel meeting and subsequent round of comments by email led to agreement on the best suitable test set.

Results

The final consensus set contains instruments in functional, cognitive, phycological, and somatic domains, and patient preferences, nutritional status and fall risk. The set comprises a patient questionnaire (six instruments) and a professional-administered test set (including ten instruments). Estimated time for administration in pilot testing was 20 and 40 minutes respectively.

Conclusion

We propose a consensus-based nephrology-tailored geriatric assessment, to benefit clinical care for older (pre-)ESKD patients and enhance research comparability. Future research should investigate effectiveness, feasibility of implementation, patients satisfaction and the value for treatment decision making and outcome improvement.

Funding

  • Private Foundation Support