Project on Geriatric Assessment in Nephrology Unit: Evaluation of Frailty and Vulnerability, Physical Capacity, and Kidney Function

Background: Improve geriatric assessment in Nephrology Unit. Methods: Phase 1: Evaluation of subjective well-being (SWB) (1 to 10) and experience on diet, exercise, sleep, self-care, medication adherence, daily activity, socio-familial environment, and emotional state (1 to 3). P 2: Evaluation anthropometric (AM) (BMI, circumference upper extremity relaxed-contracted), grip strength (GS). P 3: Study orthostatic hypotension (OH) (diastolic DBP, systolic SBP) in supine (SUP), orthostatic (ORT), and late orthostatic (ORT LATE) . P 4: Evaluation frailty index (FI) (FRAIL, Clinical Frailty Scale, VIG FRAIL), SPPB, Get Up and Go Test (GUGT). P 5: Study analytical variables (SAV). P 6: Follow-up vulnerable elderly (VE) Results: 506 consultations : ages 65-74y (A) 166, 75-84 (MA) 268, over 85 (L) 70, and under 65 (C) 332. 67% male In elderly SWB: SWB by groups: C 7.47, A 7.46, MA 7.13, L 7.71. Influencing factors >65 y: emotional state (t 4.351 p<0.001) and exercise (t 2.312 p 0.021). In elderly with CKD, socio-familial environment (t 2.723 p 0.007). Social vulnerability: 27.7% without CKD, 29.9% with CKD (p=0.737). AM - GS: Age associated with strength (r -0.297 p<0.001), better with CKD (r -0.405 p<0.001). Lower strength in CKD (24.8 vs 28.3 p=0.071). OH: In CKD where DBP decreases (DBP SUP to DBP ORT 5.7 vs -2.32 p<0.001) and DBP SUP to DBP ORT LATE 6.1 to -1.36 p=0.003). FI: Age associated with SPPB (r -0.471 p=0.001), FRAIL (r=0.419 p<0.001), Clinical Frailty Scale (r=0.476 p<0.001), VIG FRAIL (r=0.490 p=0.003), GUGT (r=0.406 p=0.013). In CKD, age associated with SPPB (r -0.470 p=0.008), FRAIL (r=0.363 p=0.005), Clinical Frailty Scale (r=0.375 p=0.004), VIG FRAIL (r=0.524 p=0.009), GUGT (r=0.512 p=0.006). SAV: Age associated with eGFR CREAT (r -0.165 p=0.026), eGFR CYS (r=-0.363 p=0.006), eGFR CREATCYS (r=-0.347 p<0.001), and Hb (r=-0.250 p<0.001). VE: Social vulnerability: 27.7% without CKD, 29.9% with CKD (p=0.737). SWB worse in negative environments (6.31 vs 7.51 p=0.002), especially in CKD (5.63 vs 7.69 p=0.025). Conclusion: In elderly age correlates with grip strength and frailty, especially in CKD. Elderly with CKD exhibit greater diastolic OH. eGFR by cystatin better associated with age and Hb . Significant vulnerability, slightly higher in CKD, affects SWB. CKD impacts elderly patients' emotional, physical, hemodynamic status, and vulnerability.