Possibilities of a patient-oriented approach in elderly and senile patients with chronic kidney disease


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Abstract

Objective. Evaluation of the possibilities and difficulties of a patient-oriented approach in elderly and senile patients with chronic kidney disease. Material and methods. The study involved 214 elderly and senile patients with stable cardiovascular pathology. The follow-up period was 12 months. CKD was diagnosed according to the national recommendations of the Scientific Society of Nephrologists of Russia (2012). To assess comorbidity, the Charlson comorbidity index (IC) was used. Cognitive status was assessed using the MMSE and the Clinical Dementia Rating (CDR) scale. Assessment of socio-demographic characteristics and awareness of patients was determined by questionnaires and interviews. Results. CKD was observed in 144 (67.3%) patients. A third of elderly and senile patients with CKD (48; 33%) are informed about decreased kidney function (n = 144), and only 23 (16%) elderly and senile patients with CKD, along with observation by a therapist, consulted a nephrologist. In 70 (48.6%) patients of elderly and senile age with stable cardiovascular pathology and CKD, pre-dementia cognitive impairment was observed, in 28 (19.4%) - mild dementia. 112 (77.8%) patients would like to be able to remotely communicate with medical personnel in case of health problems, while only 37 (25.7%) patients with CKD are ready to attend full-time schools for patients. Conclusion. Cognitive impairment and low awareness of elderly and senile patients with chronic kidney disease complicate the implementation of a patient-oriented approach.

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About the authors

E. V Efremova

Ulyanovsk State University

Email: lena_1953@mail.ru
Department of Therapy and Occupational Diseases, Faculty of Medicine, Institute of Medicine, Ecology and Physical Education Ulyanovsk, Russia

A. M Shutov

Ulyanovsk State University

Email: amshu@mail.ru
Department of Therapy and Occupational Diseases, Faculty of Medicine, Institute of Medicine, Ecology and Physical Education Ulyanovsk, Russia

A. D Semenov

Ulyanovsk State University

Email: tarantulalex98@gmail.com
Department of Therapy and Occupational Diseases, Faculty of Medicine, Institute of Medicine, Ecology and Physical Education Ulyanovsk, Russia

K. O Volkova

Ulyanovsk State University

Email: vko030299@mail.ru
Department of Therapy and Occupational Diseases, Faculty of Medicine, Institute of Medicine, Ecology and Physical Education Ulyanovsk, Russia

A. A Samoshilova

Ulyanovsk State University

Email: annavoda@mail.ru
Department of Therapy and Occupational Diseases, Faculty of Medicine, Institute of Medicine, Ecology and Physical Education Ulyanovsk, Russia

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