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Kidney Week

Abstract: FR-PO895

Baseline Characteristics of the First Geriatric Nephrology Clinic in Mexico City

Session Information

  • Geriatric Nephrology
    November 03, 2023 | Location: Exhibit Hall, Pennsylvania Convention Center
    Abstract Time: 10:00 AM - 12:00 PM

Category: Geriatric Nephrology

  • 1300 Geriatric Nephrology

Authors

  • Fonseca-Correa, Jorge Ignacio, Instituto Nacional de Ciencias Medicas y Nutricion Salvador Zubiran, Ciudad de Mexico, Ciudad de México, Mexico
  • Henriquez Santos, Gretell, Instituto Nacional de Ciencias Medicas y Nutricion Salvador Zubiran, Ciudad de Mexico, Ciudad de México, Mexico
  • Perez de Acha Chavez, Andrea, Instituto Nacional de Ciencias Medicas y Nutricion Salvador Zubiran, Ciudad de Mexico, Ciudad de México, Mexico
  • Correa-Rotter, Ricardo, Instituto Nacional de Ciencias Medicas y Nutricion Salvador Zubiran, Ciudad de Mexico, Ciudad de México, Mexico
Background

Older adults with advanced CKD have a high burden of geriatric syndromes (GS). A Geriatric Assessment is fundamental to optimize care and help with shared decisions. In 2022 an integrated Geriatric Nephrology Clinic was opened at our Institution. Patients ≥70 years with eGFR ≤20 mL/min are referred for evaluation, interventions, and planning by a Geriatric Nephrology team. We present baseline characteristics of this population.

Methods

We included patients (pts) referred to the GNC between Jan. 2022 and Mar. 2023. Charts were reviewed and data regarding GS captured and analyzed.

Results

During this time, 71 pts were referred to clinic; 59 had non-dialysis dependent (NDD) CKD and 12 were on dialysis. Average age was 80 ±7.6 years, 50% were female, and the main cause for CKD was diabetes (49%). Dialysis pts were younger (75.8±8.8 vs. 81.6±7.1, p<0.05), more likely to have healthcare coverage (66.7% vs. 32.2%, p=0.03) and had lower comorbidity (CCI 6.5±1.3 vs. 8.14±3.2, p<0.05). Dialysis vintage was 2 years (IQR 1,4). NDD pts had an average eGFR of 14.2 mL/min, 79% had ≥A2 albuminuria. Risk of progression to CKD was high (2-year KFRE >20%) in 61%. Dialysis pts had better physical performance (SPPB 9.5±1.8 vs. 6.8±2.4 points, p<0.001). No other differences were found. Burden of GS was high, with an average of 6.7±2.2 out of 14 possible. Prevalence of individual GS was: 1) frailty 62%, 2) ADL disability 46%, 3) IADL disability 61%, 4) impaired mobility 56%, 5) falls 51%, 6) low physical performance 78% 7) slow gait 46%, 8) visual deficit 42%, 9) auditory deficit 40%, 10) malnutrition 11%, 11) positive depression screening 16%, 12) altered sleep 21%, 13) abnormal cognitive screening 49%, 14) polypharmacy 91%. After the first visit, 13% of NDD pts opted for dialysis, 24% were undecided, 49% opted for conservative or palliative care and 14% did not answer. One dialysis pt asked for assistance with dialysis discontinuation.

Conclusion

The Geriatric Nephrology Clinic has been fundamental to identify and intervene in geriatric syndromes for our older patients with CKD. Patients referred to our clinic have high comorbidity, high geriatric syndrome burden and are mostly managed conservatively.