#6140 DEPENDENCE IN THE ELDERLY PATIENT ON HEMODIALYSIS

Abstract

Abstract Background and Aims Frailty constitutes a syndrome, characterized by loss of lean body mass (sarcopenia), weakness, and decreased resistance to physical exercise, which leads to decreased activity and a poor response to stress. Reduced activity, in turn, worsens sarcopenia and weakness, leading to a vicious cycle toward functional decline and increased risk of death. Frail patients starting HD may lose independence, as their functional capacity deteriorates, with increased frailty and sarcopenia, especially in the elderly. Aims: Observe the clinical differences in elderly patients on hemodialysis depending on whether they are dependent or not and observe if dependence has an impact on the dialysis regimen used. Method Observational descriptive study for 1 year in patients of the chronic hemodialysis program of four out-of-hospital centers and a hospital unit of the Fundación Renal Íñigo Álvarez de Toledo (Spain). Of the total number of patients receiving dialysis in the units, 107 over 75 years of age, who had been in the program for more than 3 months and who had signed the informed consent, were included in the study. The variables considered for the study were: age, sex, height, weight, and body mass index (BMI), etiology of kidney disease, time on hemodialysis, residual diuresis > 500 mL/min, and type of vascular access. In relation to the hemodialysis regimen, the duration variables were collected in hours of the HD session at the beginning of the program and at the time of the study, weekly hours and days per week Analytically determined: albumin, total iron binding capacity (TIBC) and creatinine. In addition, the measure of dialysis efficacy was established by eKt/V To assess the degree of functional dependency, the Barthel index is considered the most appropriate scale to assess the basic activities of daily living (BADL), obtaining a quantitative estimate of the degree of dependency. Results Association between dependency and the rest of the qualitative variables. Data expressed n (%) or mean ± SD. Conclusion Dependent patients have lower residual renal function, greater comorbidity, less ability to walk, and therefore need transportation to go to dialysis, live in residences, and are extremely tired at the end of dialysis.