P0806RESIDUAL RENAL FUNCTION IS COMPLEMENTARY TO GERIATRIC ASSESSMENT SCORE IN ASSESSING CLINICAL RISK OF ELDERLY PATIENTS

Abstract

Abstract Background and Aims Renal function impairment is highly pervasive in the elderly and triggers increased morbidity and mortality. Comprehensive geriatric assessment (CGA) is a validated multidisciplinary instrument to assess medical, psychosocial and functional limitations of old patients with diagnostic and risk-stratification purposes. In a focused cohort of frail individuals, we aimed at evaluating possible relationships between single CGA items and renal function. Method 254 consecutive elderly subjects (mean age 79.9±6.6 years, female 65.8%) from the geriatric division of a large Italian community hospital were studied. We collected clinical data including CGA and renal function (CKD-EPI formula). CGA single items included the Cumulative Illness Rating Scale (CIRS), the Exton Smith Scale (ESS), the Mini Nutritional Assessment Short Form (MNA-SF), the Katz‘s Activities of Daily Living (ADL), the Lawton’s Instrumental Activities of Daily Living (IADL), the Short Portable Mental Status Questionnaire (SPMSQ) and the amount of drugs administered (AD). Results Mean eGFR was 66.37±30.94 mL/min/1.73 m2. Overall, the reported CIRS, ESS, MNA, ADL and AD scores were low (7.6±3.3) while IADL and SPMQ were on a mild range, denoting a potential alarm signal for poor prognosis and the risk for adverse outcomes. At univariate analyses, eGFR was significantly associated with CIRS (R=-0.389, p<0.0001), ESS (R=0.355, p<0.0001), MNA (R=0.394, p<0.0001), ADL (R=0.394, p<0.0001), AD (R=-0.374, p<0.0001. while a weak, although significant correlation was found with IADL (R=0.131, p=0.038) and SPMSQ (R=-0.141, p=0.038). In a fully adjusted multivariate analyses only SPMSQ (ß=-0.174, p=0.04), ADL (ß=0.182, p=0.012), IADL (ß =0.209, p=0.003) and AD (ß=-0.354, p<0.0001) remained significant predictors of residual renal function. Conclusion In elderly frail subjects, residual renal function may influence daily life and cognitive activities, the perceived quality of living and the entity of drug assumption. Inclusion of renal function within a comprehensive geriatric assessment could help improving risk stratification in the elderly