A simple six-question quiz, typically used to assess disabilities in the elderly, could help doctors determine which kidney dialysis patients of any age are at the greatest risk of death, new Johns Hopkins research suggests.
Believing that kidney failure mimics an accelerated body-wide aging process transplant surgeon Dorry L. Segev, M.D., Ph.D., and his colleagues turned to geriatric experts to examine mortality risk in patients undergoing dialysis. They found that those who needed assistance with one or more basic activities of daily living - feeding, dressing, walking, grooming, using a toilet and bathing - were more than three times more likely to die than their more independent counterparts.
"This quiz helps us identify an at-risk group that would probably benefit from closer monitoring and maybe even physical therapy to improve their functioning," says Segev, an associate professor of surgery at the Johns Hopkins University School of Medicine and leader of the study published in the Journal of the American Geriatrics Society.
Needing assistance with basic activities of daily living has been well documented in the geriatrics field as a predictor of adverse outcomes, says Segev, Johns Hopkins' director of clinical research in transplant surgery.
"The thing that puts older patients at risk for adverse outcomes is a decrease in physiological reserve," he says. "Organ systems start to deteriorate and when they don't function as well as they used to, they can't handle stressors as well as they used to. There's growing evidence that dialysis and kidney failure not only represent deterioration of kidney function but also cause deterioration of function in other organ systems."