(HealthDay News) — For older adults initiating dialysis, many experience a decline in functional status after 6 months, and the prevalence of high caregiver burden increases, according to a study published online in the Clinical Journal of the American Society of Nephrology.

Namiko A. Goto, MD, from the University Medical Center Utrecht in the Netherlands, and colleagues examined correlations among dialysis initiation in an elderly population, functional status, and caregiver burden. Data were included for 187 participants aged ≥65 years with end-stage kidney disease who underwent a geriatric assessment and a frailty screening at the time of dialysis initiation.

The researchers found that 79% of participants were care-dependent in functional status at the start of dialysis. After 6 months, 40% of participants experienced a decline in functional status, 34% remained stable, 18% improved, and 8% died. There was a significant increase in the prevalence of high caregiver burden from 23% to 38%. Age (odds ratio, 1.05 per year older at baseline; 95% confidence interval [CI], 1.00 to 1.10) and a high Groningen Frailty Indicator score compared with a low score (odds ratio, 1.97; 95% CI, 1.05 to 3.68) correlated with functional decline/death in multivariable analysis.

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“Further research should focus on improving the identification of patients at risk for functional decline and interventions that could maintain functional status,” the authors write.

The study was partially funded by AstraZeneca.


Goto NA, van Loon IN, Boereboom FTJ, et al. Association of Initiation of Maintenance Dialysis with Functional Status and Caregiver Burden. Clin J Am Soc Nephrol. 

Abel DL. Functioning on Dialysis: An Oxymoron? Clin J Am Soc Nephrol. June 2019, CJN.05870519; doi:10.2215/CJN.05870519

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