R B Curtin, B L Svarstad, D Andress, T Keller, P Sacksteder
Hemodialysis patients' compliance with their therapeutic regimens, including dietary and fluid restrictions, dialysis treatments and medications, is generally suboptimal. Recently, the mean age of the dialysis population has increased. Since impaired cognitive function, which sometimes accompanies aging, interferes with the ability to comprehend instructions, elderly dialysis patients might be at greater risk for noncompliance than are their younger counterparts. In this project, 135 hemodialysis patients (68 patients > 65 years of age and 67 patients < or = 65 years) were studied. Rates of noncompliance with oral antihypertensives and phosphate binders, as tracked by a medication event monitoring system (MEMS), are reported here. More than 42% of older patients (> 65) and 47% of younger patients (< or = 65) were repeated noncompliers with antihypertensives, missing at least 20% of the prescribed doses. Similarly, 65% of older patients and 80% of younger patients exhibited repeated noncompliance with phosphate binders. Almost 30% of older patients and more than 32% of younger patients missed their antihypertensives completely on 20% or more of the prescribed days. Only 18% of the older subjects, but 33% of younger patients missed taking their phosphate binders for 20 or more percent of the prescribed days. Rates of noncompliance were found to differ between the two populations of patients in that younger patients made significantly more dosing errors with their antihypertensives and missed taking their phosphate binders on more days than did their older counterparts.
{"title":"Differences in older versus younger hemodialysis patients' noncompliance with oral medications.","authors":"R B Curtin, B L Svarstad, D Andress, T Keller, P Sacksteder","doi":"10.1023/a:1008267104024","DOIUrl":"https://doi.org/10.1023/a:1008267104024","url":null,"abstract":"<p><p>Hemodialysis patients' compliance with their therapeutic regimens, including dietary and fluid restrictions, dialysis treatments and medications, is generally suboptimal. Recently, the mean age of the dialysis population has increased. Since impaired cognitive function, which sometimes accompanies aging, interferes with the ability to comprehend instructions, elderly dialysis patients might be at greater risk for noncompliance than are their younger counterparts. In this project, 135 hemodialysis patients (68 patients > 65 years of age and 67 patients < or = 65 years) were studied. Rates of noncompliance with oral antihypertensives and phosphate binders, as tracked by a medication event monitoring system (MEMS), are reported here. More than 42% of older patients (> 65) and 47% of younger patients (< or = 65) were repeated noncompliers with antihypertensives, missing at least 20% of the prescribed doses. Similarly, 65% of older patients and 80% of younger patients exhibited repeated noncompliance with phosphate binders. Almost 30% of older patients and more than 32% of younger patients missed their antihypertensives completely on 20% or more of the prescribed days. Only 18% of the older subjects, but 33% of younger patients missed taking their phosphate binders for 20 or more percent of the prescribed days. Rates of noncompliance were found to differ between the two populations of patients in that younger patients made significantly more dosing errors with their antihypertensives and missed taking their phosphate binders on more days than did their older counterparts.</p>","PeriodicalId":79490,"journal":{"name":"Geriatric nephrology and urology","volume":"7 1","pages":"35-44"},"PeriodicalIF":0.0,"publicationDate":"1997-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1023/a:1008267104024","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"20350481","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Elderly patients may exhibit changes in plasma hormone levels, as well as thirst disorders. Two groups of elderly hemodialysis patients were evaluated to determine if excessive interdialytic weight gain was related to differences in postdialysis plasma osmolality or postdialysis measurement of plasma renin activity, or plasma levels of angiotensin II (a dipsogenic hormone), aldosterone, and vasopressin. Patients mean age was 77.0 +/- 8.8 years and patients were divided into groups, I and II, with less than or greater than 2 kg interdialytic weight gain. Postdialysis plasma osmolality was similar in both groups of patients (309.3 +/- 2.3 vs. 309.6 +/- 2.4 mOsm/Kg, p = 0.8) and postdialysis AVP levels also were no different (2.7 +/- 0.6 vs. 2.1 +/- 0.2 pg/mL, p = 0.3). There was also no statistical difference between postdialysis angiotensin II and aldosterone levels in either group of patients. Plasma renin activity (PRA) was also not different in either group (2.3 +/- 1.1 vs. 0.43 +/- 0.1 ng/mL/hr, p = 0.1), but group I patients, with less than 2 kg weight gain, tended to exhibit higher PRA values perhaps reflecting proximity to their dry weight postdialysis. Since excessive fluid intake did not appear to relate to plasma osmolality and hormone levels studied, it might be suggested that excessive drinking could be due to excessive sodium intake associated with personal dietary habits or perhaps other as yet unmeasured factors.
老年患者可能表现出血浆激素水平的变化，以及口渴障碍。对两组老年血液透析患者进行评估，以确定过度的透析间期体重增加是否与透析后血浆渗透压或透析后血浆肾素活性测量或血浆血管紧张素II(一种糖尿病激素)、醛固酮和血管加压素水平的差异有关。患者的平均年龄为77.0±8.8岁，患者分为I组和II组，透析间期体重增加小于或大于2 kg。两组患者的透析后血浆渗透压相似(309.3 +/- 2.3 vs 309.6 +/- 2.4 mOsm/Kg, p = 0.8)，透析后AVP水平也无差异(2.7 +/- 0.6 vs 2.1 +/- 0.2 pg/mL, p = 0.3)。两组患者透析后血管紧张素II和醛固酮水平也无统计学差异。血浆肾素活性(PRA)在两组中也没有差异(2.3 +/- 1.1 vs. 0.43 +/- 0.1 ng/mL/hr, p = 0.1)，但体重增加小于2 kg的I组患者往往表现出更高的PRA值，这可能反映了透析后他们的干重接近。由于过量的液体摄入似乎与所研究的血浆渗透压和激素水平无关，因此可能建议过量饮酒可能是由于与个人饮食习惯或其他尚未测量的因素相关的过量钠摄入所致。
{"title":"Evaluation of plasma osmolality and hormone responses in elderly chronic hemodialysis patients with excessive interdialytic weight gain.","authors":"R Samuel-Variath, R Chan, M F Michelis","doi":"10.1023/a:1008294601458","DOIUrl":"https://doi.org/10.1023/a:1008294601458","url":null,"abstract":"<p><p>Elderly patients may exhibit changes in plasma hormone levels, as well as thirst disorders. Two groups of elderly hemodialysis patients were evaluated to determine if excessive interdialytic weight gain was related to differences in postdialysis plasma osmolality or postdialysis measurement of plasma renin activity, or plasma levels of angiotensin II (a dipsogenic hormone), aldosterone, and vasopressin. Patients mean age was 77.0 +/- 8.8 years and patients were divided into groups, I and II, with less than or greater than 2 kg interdialytic weight gain. Postdialysis plasma osmolality was similar in both groups of patients (309.3 +/- 2.3 vs. 309.6 +/- 2.4 mOsm/Kg, p = 0.8) and postdialysis AVP levels also were no different (2.7 +/- 0.6 vs. 2.1 +/- 0.2 pg/mL, p = 0.3). There was also no statistical difference between postdialysis angiotensin II and aldosterone levels in either group of patients. Plasma renin activity (PRA) was also not different in either group (2.3 +/- 1.1 vs. 0.43 +/- 0.1 ng/mL/hr, p = 0.1), but group I patients, with less than 2 kg weight gain, tended to exhibit higher PRA values perhaps reflecting proximity to their dry weight postdialysis. Since excessive fluid intake did not appear to relate to plasma osmolality and hormone levels studied, it might be suggested that excessive drinking could be due to excessive sodium intake associated with personal dietary habits or perhaps other as yet unmeasured factors.</p>","PeriodicalId":79490,"journal":{"name":"Geriatric nephrology and urology","volume":"7 3","pages":"131-5"},"PeriodicalIF":0.0,"publicationDate":"1997-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1023/a:1008294601458","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"20417442","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Harry G. Preuss, S. Jarrell, N. Bushehri, Victor Onyejiaka, N. Mirdamadi-Zonozi
{"title":"Nutrients and trace elements as they affect blood pressure in the elderly","authors":"Harry G. Preuss, S. Jarrell, N. Bushehri, Victor Onyejiaka, N. Mirdamadi-Zonozi","doi":"10.1007/BF00249633","DOIUrl":"https://doi.org/10.1007/BF00249633","url":null,"abstract":"","PeriodicalId":79490,"journal":{"name":"Geriatric nephrology and urology","volume":"6 1","pages":"169-179"},"PeriodicalIF":0.0,"publicationDate":"1997-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1007/BF00249633","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"51090249","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Renal sodium transport in healthy elderly and elderly with systolic hypertension","authors":"Huamin Wang, Ming-Zi Zhang, Haiyan Wang","doi":"10.1007/BF00451972","DOIUrl":"https://doi.org/10.1007/BF00451972","url":null,"abstract":"","PeriodicalId":79490,"journal":{"name":"Geriatric nephrology and urology","volume":"6 1","pages":"13-19"},"PeriodicalIF":0.0,"publicationDate":"1996-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1007/BF00451972","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"51317050","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Peritoneal dialysis in the nineth decade of life experience in a single center","authors":"A. Vecchi, M. Maccario, C. Ponticelli","doi":"10.1007/BF00451110","DOIUrl":"https://doi.org/10.1007/BF00451110","url":null,"abstract":"","PeriodicalId":79490,"journal":{"name":"Geriatric nephrology and urology","volume":"6 1","pages":"75-80"},"PeriodicalIF":0.0,"publicationDate":"1996-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1007/BF00451110","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"51314790","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Rehabilitation of the elderly patient on dialysis","authors":"N. Kutner","doi":"10.1007/BF00451111","DOIUrl":"https://doi.org/10.1007/BF00451111","url":null,"abstract":"","PeriodicalId":79490,"journal":{"name":"Geriatric nephrology and urology","volume":"6 1","pages":"81-88"},"PeriodicalIF":0.0,"publicationDate":"1996-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1007/BF00451111","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"51314798","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
K. Hansen, M. Benjamin, R. G. Appel, T. Craven, R. Dean
{"title":"Renovascular hypertension in the elderly: Results of surgical management","authors":"K. Hansen, M. Benjamin, R. G. Appel, T. Craven, R. Dean","doi":"10.1007/BF00451971","DOIUrl":"https://doi.org/10.1007/BF00451971","url":null,"abstract":"","PeriodicalId":79490,"journal":{"name":"Geriatric nephrology and urology","volume":"6 1","pages":"3-11"},"PeriodicalIF":0.0,"publicationDate":"1996-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1007/BF00451971","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"51317038","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Lisinopril has no natriuretic effect in elderly: A study of the single-dose response in aged vs young individuals","authors":"D. Chevet, J. Mallié, C. Jeandel","doi":"10.1007/BF00451109","DOIUrl":"https://doi.org/10.1007/BF00451109","url":null,"abstract":"","PeriodicalId":79490,"journal":{"name":"Geriatric nephrology and urology","volume":"6 1","pages":"69-74"},"PeriodicalIF":0.0,"publicationDate":"1996-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1007/BF00451109","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"51314779","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Clinical physiology — pharmacology: multifactorial hypocalcemia in an elderly patient with myeloproliferative disorder","authors":"D. Maggio, A. Cherubim, U. Senin, D. Lowenthal","doi":"10.1007/BF00451115","DOIUrl":"https://doi.org/10.1007/BF00451115","url":null,"abstract":"","PeriodicalId":79490,"journal":{"name":"Geriatric nephrology and urology","volume":"6 1","pages":"113-117"},"PeriodicalIF":0.0,"publicationDate":"1996-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1007/BF00451115","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"51314840","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
J. Jessup, D. Lowenthal, M. Pollock, K. Smyth, L. Williams, J. Ruiz, M. Fagien, L. Garzarella
{"title":"Exercise training in older men and women: Effects on cardiovascular and renal function","authors":"J. Jessup, D. Lowenthal, M. Pollock, K. Smyth, L. Williams, J. Ruiz, M. Fagien, L. Garzarella","doi":"10.1007/BF00451974","DOIUrl":"https://doi.org/10.1007/BF00451974","url":null,"abstract":"","PeriodicalId":79490,"journal":{"name":"Geriatric nephrology and urology","volume":"6 1","pages":"27-34"},"PeriodicalIF":0.0,"publicationDate":"1996-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1007/BF00451974","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"51317088","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
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