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• W4205122538 abstract "BACKGROUND: It is unclear whether functional status before dialysis is maintained after the initiation of this therapy in elderly patients with end-stage renal disease (ESRD).METHODS: Using a national registry of patients undergoing dialysis, which was linked to a national registry of nursing home residents, we identified all 3702 nursing home residents in the United States who were starting treatment with dialysis between June 1998 and October 2000 and for whom at least one measurement of functional status was available before the initiation of dialysis. Functional status was measured by assessing the degree of dependence in seven activities of daily living (on the Minimum Data Set-Activities of Daily Living [MDS-ADL] scale of 0 to 28 points, with higher scores indicating greater functional difficulty).RESULTS: The median MDS-ADL score increased from 12 during the 3 months before the initiation of dialysis to 16 during the 3 months after the initiation of dialysis. Three months after the initiation of dialysis, functional status had been maintained in 39% of nursing home residents, but by 12 months after the initiation of dialysis, 58% had died and predialysis functional status had been maintained in only 13%. In a random-effects model, the initiation of dialysis was associated with a sharp decline in functional status, indicated by an increase of 2.8 points in the MDS-ADL score (95% confidence interval [CI], 2.5 to 3.0); this decline was independent of age, sex, race, and functional-status trajectory before the initiation of dialysis. The decline in functional status associated with the initiation of dialysis remained substantial (1.7 points; 95% CI, 1.4 to 2.1), even after adjustment for the presence or absence of an accelerated functional decline during the 3-month period before the initiation of dialysis.CONCLUSIONS: Among nursing home residents with ESRD, the initiation of dialysis is associated with a substantial and sustained decline in functional status.2009 Massachusetts Medical Society PMID: 19828531 Funding information This work was supported by: NCRR NIH HHS, United States Grant ID: KL2RR024130 NIA NIH HHS, United States Grant ID: K24 AG029812 NIA NIH HHS, United States Grant ID: K23 AG028952 NCRR NIH HHS, United States Grant ID: KL2 RR024130 NIA NIH HHS, United States Grant ID: K23AG028952 NIDDK NIH HHS, United States Grant ID: N01DK12450 NIA NIH HHS, United States Grant ID: K23 AG028952-01A1 More Less keyboard_arrow_down" @default.
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• W4205122538 date "2009-11-16" @default.
• W4205122538 modified "2023-10-16" @default.
• W4205122538 title "Faculty Opinions recommendation of Functional status of elderly adults before and after initiation of dialysis." @default.
• W4205122538 doi "https://doi.org/10.3410/f.1199977.665079" @default.
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