The relationship between death from renal insufficiency and diuretic therapy among older adults at two nursing homes catering atomic bomb survivors
| Autor: | Masakuni Wagou, Kazuhiro Abe, Naoshi Saheki, Kosuke Okada, Nanao Kamada, Masahiro Okada, Yumiko Yamaguchi, Shigeko Katoh, Hidemi Sasaki |
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| Rok vydání: | 2018 |
| Předmět: |
Male
Pediatrics medicine.medical_specialty medicine.medical_treatment Renal function chemistry.chemical_compound Japan medicine Humans In patient Renal Insufficiency Survivors Diuretics Aged Aged 80 and over Nuclear Weapons Creatinine Kidney business.industry Case-control study Nursing Homes medicine.anatomical_structure chemistry Spironolactone Female Geriatrics and Gerontology Diuretic Nursing homes business |
| Zdroj: | Nippon Ronen Igakkai Zasshi. Japanese Journal of Geriatrics. 55:640-649 |
| ISSN: | 0300-9173 |
| DOI: | 10.3143/geriatrics.55.640 |
| Popis: | AIM In Geriatrics Gerontology International we previously reported the efficacy of reducing diuretics to prevent falls and fractures in older adults. We have since noticed another important problem, regarding the diuretic therapy for older adults with decreased muscle and water volumes. We performed a study on renal insufficiency and diuretic therapy in an attempt to confirm the need for case control study between standard diuretic therapy administered, according to guidelines and "NY-mode" diuretic therapy, which involves the administration of the mineral-corticoid receptor inhibitor spironolactone at 12.5 mg orally every other day. METHODS We reviewed the causes of death among 1,855 residents living at 2 atomic bomb survivors nursing homes, with a focus on the death certification and diuretic therapy status of 48 older adults who died due to renal insufficiency. We also evaluated the relationship between the estimated glomerular filtration rate of 407 residents using serum creatinine data and the level of independence in daily life of disabled older adults. RESULTS We found that deaths due to chronic renal insufficiency were concentrated within certain period in two nursing homes examined and in patients receiving standard diuretic therapy (continuous daily loop diuretics or combination of loop diuretics with mineral-corticoid receptor inhibitor). Older adults with a relatively low level of independence in daily life showed a relatively higher estimated glomerular filtration rate, depending on their muscle volume. CONCLUSION These results suggest the need for a case control study of standard diuretic therapy and "NY-mode" therapy among older adults with decreased muscle and water volumes to not only prevent falls and fall-related fractures but also protect the kidney from damage. |
| Databáze: | OpenAIRE |
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