Avaliação dos aspectos físicos e mentais em pacientes longevos com doença renal crônica
Data
2017-12-21
Autores
Martini, Adriana Ferreira 
Orientadores
Sesso, Ricardo de Castro Cintra
Tipo
Dissertação de mestrado
Título da Revista
ISSN da Revista
Título de Volume
Resumo
Objetivos: Avaliar pacientes idosos longevos (≥80 anos) com doença renal crônica (DRC) em tratamento conservador (taxa de filtração glomerular ≤30 ml/min/1,73m2) em relação à qualidade de vida utilizando o questionário SF-36. Avaliar aspectos físicos e mentais usando escalas padronizadas. Estudar associações entre aspectos sóciodemográficos, suporte social, aspectos clínicos e laboratoriais, e as medidas e qualidade de vida, avaliação física, mental e depressão em comparação a idosos da comunidade.Métodos: Foram estudados 80 pacientes com DRC e 60 idosos longevos vivendo na comunidade (controles), com média de idade de 83,7 anos (DP=3,3 anos). Foram analisados aspectos físicos, cognitivos, sociais e de qualidade de vida por meio de escalas, como: SF-36, mini mental, teste de nomeação de Boston, teste sentar e levantar, TUG, ABVD, MOS, escala de depressão GDS, teste de fluência verbal categoria animais e questionário para aplicação Abep.Resultados: O grupo com doença renal crônica apresentou maior média do índice de comorbidades de Charlson (p<0,001), maior porcentagem de diabetes mellitus (p = 0,002) e de diabetes mellitus com dano de orgão alvo (p<0,001). O grupo controle apresentou médias maiores nas dimensões de capacidade funcional (p=0,007), estado de saúde geral e limitações por aspectos emocionais (p<0,001), vitalidade e limitações por aspectos físicos (p = 0,001); e na fluência verbal (teste de Boston) (p<0,001) comparativamente ao grupo com doença, que por sua vez, apresentou médias maiores nas dimensões de saúde mental, aspectos sociais (p=0,001) e maior porcentagem de indivíduos com tempo acima de 20 segundos no teste de sentar-se e levantar-se da cadeira (p = 0,002). Conclusões: Pacientes longevos com DRC estágio 4 e 5 em tratamento conservador, apresentaram uma pior avalição de sua saúde geral, função fisica e limitação por aspectos emocionais investigados pelo questionário SF-36, como também em outras medidas objetivas de desempenho físico em relação a longevos sem doença renal da comunidade. Além disso, esses pacientes têm indícios de menor desempenho cognitivo (fluência verbal) e apoio social. Entretanto outros aspectos medidos por ABVD, índices de depressão, e função emocional parecem similares a da população sem DRC. Esses achados são importantes para se conhecer o desempenho funcional físico e mental dos pacientes longevos com DRC auxiliando na tomada de decisão para se aprimorar seu tratamento
Objectives: To evaluate elderly patients (≥80 years) with chronic renal disease (CKD) in conservative treatment (glomerular filtration rate ≤30 ml / min / 1.73m2) in relation to quality of life using the SF-36 questionnaire. Evaluate physical and mental aspects using standardized scales. To study associations between socio-demographic aspects, social support, clinical and laboratorial aspects, and measures and quality of life, physical, mental and depression evaluation. Methods: 80 patients with CKD and 60 elderly individuals living in the community (controls) were studied, with a mean age of 83.7 years (SD = 3.3 years). Physical, cognitive, social and quality of life aspects were analyzed through scales such as: SF-36, mini mental, Boston naming test and others. Results: The group with chronic kidney disease presented higher mean Charlson comorbidities index (p <0.001), higher percentages of diabetes mellitus (p = 0.002), diabetes mellitus with target organ damage (p <0.001). The control group had higher mean physical functioning (p = 0.007), general health and emotional well-being (p <0.001), energy / fatigue and physical composition (p = 0.001), verbal fluency: Boston test (p <0.001) (p = 0.001) and a higher percentage of time over 20 seconds in the sit-up and stand-up test (p = 0.002). Conclusions: Long-term patients with CKD stage 4 and 5 in conservative treatment usually present several comorbidities, which may be reflected in a worse evaluation of their general health and physical function investigated by the SF-36 questionnaire, as well as other objective measures regarding longevity without community kidney disease. In addition, these patients have evidence of lower cognitive performance (verbal fluency) and social support. However, other aspects measured by ABVD, indices of depression, and emotional function seem similar to those of the non-CKD population. These findings are important to know the physical and mental functional performance of patients with CKD, helping in decision making to improve their treatment.
Objectives: To evaluate elderly patients (≥80 years) with chronic renal disease (CKD) in conservative treatment (glomerular filtration rate ≤30 ml / min / 1.73m2) in relation to quality of life using the SF-36 questionnaire. Evaluate physical and mental aspects using standardized scales. To study associations between socio-demographic aspects, social support, clinical and laboratorial aspects, and measures and quality of life, physical, mental and depression evaluation. Methods: 80 patients with CKD and 60 elderly individuals living in the community (controls) were studied, with a mean age of 83.7 years (SD = 3.3 years). Physical, cognitive, social and quality of life aspects were analyzed through scales such as: SF-36, mini mental, Boston naming test and others. Results: The group with chronic kidney disease presented higher mean Charlson comorbidities index (p <0.001), higher percentages of diabetes mellitus (p = 0.002), diabetes mellitus with target organ damage (p <0.001). The control group had higher mean physical functioning (p = 0.007), general health and emotional well-being (p <0.001), energy / fatigue and physical composition (p = 0.001), verbal fluency: Boston test (p <0.001) (p = 0.001) and a higher percentage of time over 20 seconds in the sit-up and stand-up test (p = 0.002). Conclusions: Long-term patients with CKD stage 4 and 5 in conservative treatment usually present several comorbidities, which may be reflected in a worse evaluation of their general health and physical function investigated by the SF-36 questionnaire, as well as other objective measures regarding longevity without community kidney disease. In addition, these patients have evidence of lower cognitive performance (verbal fluency) and social support. However, other aspects measured by ABVD, indices of depression, and emotional function seem similar to those of the non-CKD population. These findings are important to know the physical and mental functional performance of patients with CKD, helping in decision making to improve their treatment.