Quiz, already used in elderly, could determine death risk for kidney dialysis patients of all ages

A simple six-question quiz, typically used to assess disabilities in the elderly, could help doctors determine which kidney dialysis patients of any age are at the greatest risk of death, new Johns Hopkins research suggests.

Believing that kidney failure mimics an accelerated body-wide aging process Dorry L. Segev, M.D., Ph.D., and his colleagues turned to geriatric experts to examine in patients undergoing dialysis. They found that those who needed assistance with one or more basic activities of daily living – feeding, dressing, walking, grooming, using a toilet and bathing – were more than three times more likely to die than their more independent counterparts.

"This quiz helps us identify an at- that would probably benefit from closer monitoring and maybe even physical therapy to improve their functioning," says Segev, an associate professor of surgery at the Johns Hopkins University School of Medicine and leader of the study published in the .

Needing assistance with basic activities of daily living has been well documented in the geriatrics field as a predictor of adverse outcomes, says Segev, Johns Hopkins' director of clinical research in transplant surgery.

"The thing that puts older patients at risk for adverse outcomes is a decrease in physiological reserve," he says. " start to deteriorate and when they don't function as well as they used to, they can't handle as well as they used to. There's growing evidence that dialysis and kidney failure not only represent deterioration of but also cause deterioration of function in other organ systems."

More than 600,000 people in the United States are on dialysis because their kidneys can no longer efficiently filter toxins from the blood and remove them from the body. Dialysis often must be done several times a week for several hours at a time, a time-consuming and draining ordeal required to keep patients with kidney failure alive.

Segev and his team followed 143 patients undergoing dialysis, all recruited from a dialysis center in Baltimore between January, 2009 and March, 2010. They were followed until November 15, 2011. There were 33 deaths during the study period, and the risk of death did not vary with age.

The prevalence of disability in the activities of daily living of patients of all ages – 41 percent in this study – is strikingly higher than in older adults in the community at-large (5 to 8.1 percent of non-institutionalized adults over age 65).

"Measuring a dialysis patient's ability to perform activities of daily life may be an important tool," says Mara A. McAdams-DeMarco, Ph.D., a Johns Hopkins epidemiologist and contributor to the study. "This information is simple to capture, doesn't require sophisticated tests and could help us better target the right patients for intervention."

More information: For more information: www.hopkinsmedicine.org/transplant

Related Stories

Seniors stymied in wait for kidney transplants

Feb 16, 2010

One-third of people over the age of 65 wait longer than necessary for lifesaving, new kidneys because their doctors fail to put them in a queue for organs unsuitable to transplant in younger patients but well-suited to seniors, ...

Recommended for you

Two expats die of MERS in Saudi commercial hub

6 hours ago

Two foreigners died of MERS in the Saudi city of Jeddah, the health ministry said Saturday, as fears rise over the spreading respiratory virus in the kingdom's commercial hub.

UAE reports 12 new cases of MERS

6 hours ago

Health authorities in the United Arab Emirates have announced 12 new cases of infection by the MERS coronavirus, but insisted the patients would be cured within two weeks.

Filipino tests negative for Middle East virus

18 hours ago

A Filipino nurse who tested positive for the Middle East virus has been found free of infection in a subsequent examination after he returned home, Philippine health officials said Saturday.

User comments