Doença renal crônica e tratamento em idosos: uma revisão integrativa

Prevalence and incidence of decreased glomerular filtration rate and its variation over 6 years: Cohort study SABE 2010-2016

The aging process and the rising prevalence of Chronic Noncommunicable Diseases (NCDs) contribute to the decline in kidney function among elderly individuals. The aim of this research was to assess prevalence and incidence of decreased glomerular filtration rate (GFR) (GFR <60mL/min/1.73m2) over six-year period in elderly residents of São Paulo. This study relied on data from 2010 and 2016 waves of the cohort SABE Study - Health, Wellbeing, and Aging, with a probabilistic and representative sample of elderly individuals residing in São Paulo. GFR was calculated using the 2021 Chronic Kidney Disease Epidemiology Collaboration creatinine (CKD-EPI) equation. Categorical variables were analyzed using chi-square test with Rao-Scott correction, and weighted means and standard errors were calculated for continuous variables. Logistic and linear regression models were constructed to analyse the data. Statistical analyses accounted for sample weights to ensure population representativeness. The prevalence of decreased GFR in 2010 was 17.3%, with mean GFR of 75.6 mL/min/1.73m2 (SE = 0.5). The incidence of decreased GFR between 2010 and 2016 was 14.9%, equivalent to an annual incidence of 2.5%. This incidence was associated with older age, hypertension, self-perceived fair/poor/very poor health, and greater number of comorbidities associated. Over the study period, 68.1% of the elderly participants experienced deterioration in GFR, with an average decline of 1 mL/min/1.73m2 each year. Renal function decline often occurs without noticeable symptoms, and the high prevalence of comorbidities contributes to the worsening of GFR. Therefore, monitoring renal function in the elderly is crucial for effectively managing the health of this population.

The impact of a nutrition intervention program targeting elderly people with chronic kidney disease

Chronic kidney disease (CKD) is recognized as a complex disease that requires multiple approaches to its treatment. The aim of this study was to evaluate the impact of a nutritional intervention program on the nutritional status and quality of life of elderly pre-dialysis CKD patients. A prospective cohort study was carried out involving 64 elderly stage 3 CKD patients receiving treatment at a Primary Care Center in the Municipality of Diadema in the State of São Paulo, Brazil. The nutritional intervention consisted of one individual and three group meetings. Nutritional status was assessed using anthropometric variables and classified according to Body Mass Index (BMI). Cardiovascular risk was classified according to Waist Circumference (WC). Quality of life was assessed using the WHOQOL-BREF. The data was analyzed adopting a significance level of 5%. Mean age was 73.95 ± 7.84 years and the majority of the sample were women, had a low level of schooling, and low monthly income. With respect to nutritional status, 21.9% of the sample were underweight, 32.8% overweight, and 62.6% were at a high or very high risk of developing cardiovascular disease. The nutritional intervention program had a positive impact on nutritional status, leading to a decline in BMI and WC, reduction in risk of developing heart disease, increased satisfaction with current state of health, and improved quality of life.