Frailty, Cognitive Function and Health-related Quality of Life in Older Adults With Advanced Chronic Kidney Disease.

Frailty, Cognitive Function and Health-related Quality of Life in Older Adults With Advanced Chronic Kidney Disease: Mortality and Dialysis Initiation, a Prospective Cohort Study.

This observational study explores the impact of cognitive impairment and frailty in older adults with advanced chronic kidney disease ].

The main question[s] it aims to answer are:

• What determines the time to initiate dialysis? Cognitive impairment or frailty?
• What does predict the time to death? Presence of frailty or cognitive impairment?
• What does correlate strongly with time-low health-related quality of life? frailty or cognitive impairment?

Inclusion Criteria:

• Patients age 65 years or older.
• CKD stage 4 and 5 who were identified by two consecutive measurements of estimated glomerular filtration rate (eGFR) <30 mL/min/1.73 m2 separated by more than 3 months.

Exclusion Criteria:

• Patients younger than 65 years old.
• Chronic kidney disease stages 1,2, and 3.
• Dialysis dependence
• History of kidney transplantation.
• Initial visit with the health care provider.
• Recent acute kidney injury.
• Patients who had been hospitalized for more than 2 months before the visit (because long hospitalization might affect the degree of frailty)
• Patients with myocardial infarction and cerebrovascular accident 3 months before the assessment
• Patients who are blind or with limb amputation.
• Patients who refuse to participate.