title: Prevalence, associated factors and impact on mortality of chronic kidney disease in nursing home residents: A single-center experience.
abstract: OBJECTIVE
  We carried out the present study to determine the prevalence, associated comorbidities and impact on mortality of chronic kidney disease (CKD) in nursing home residents.
  
  
  METHODS
  This was an 8-year prospective single-center, longitudinal cohort study consisting of 612 patients living in a nursing home from 2005-2013. The glomerular filtration rate (GFR) was estimated from a prediction equation, the Chronic Kidney Disease Epidemiology Collaboration equation, based on the serum creatinine concentration, age, race, sex and body size. The demographic and clinical characteristics of the residents were collected.
  
  
  RESULTS
  CKD, defined as abnormalities of kidney structure or function, present for >3 months, with implications for health, was present in 197 (39.9%) residents. Specifically, 109 (21.5%) residents had an estimated GFR of 45-59 mL/min, and 64 (12.6%) had an estimated GFR of 30-44 mL/min. Multivariate logistic regression identified older age (OR 0.97, 95% CI 0.95-0.99), female sex (OR 2.99, 95% CI 1.99-4.49) and hypertension (OR 1.55, 95%, CI 1.00-2.40) as the only independent predictors of CKD. After a follow up of 8 years, 208 (41.1%) of the 506 residents died. Of these residents, 104 (52.8%) had CKD and 104 (33.4%) did not have CKD. The Kaplan-Meier survival curves showed that residents with CKD had a significantly higher mortality than those without CKD.
  
  
  CONCLUSIONS
  CKD is prevalent in nursing home residents. A decline in renal function is associated with cardiovascular disease and mortality. Early recognition of CKD might improve drug dosage, renal management and outcomes in this particular group of patients.
authors.affiliation: Department of Nephrology, Yeditepe University Hospital, Istanbul, Turkey.
authors.forename: Zehra
authors.initials: Z
authors.lastname: Eren
authors.affiliation: Department of Internal Medicine, Yeditepe University Hospital, Istanbul, Turkey.
authors.forename: Yaşar
authors.initials: Y
authors.lastname: Küçükardalı
authors.affiliation: Department of Internal Medicine, Yeditepe University Hospital, Istanbul, Turkey.
authors.forename: Mehmet Akif
authors.initials: MA
authors.lastname: Öztürk
authors.affiliation: Department of Psychology, Yeditepe University Medical Faculty, Istanbul, Turkey.
authors.forename: Betül
authors.initials: B
authors.lastname: Küçükardalı
authors.affiliation: Department of Biostatistics, Yeditepe University Medical Faculty, Istanbul, Turkey.
authors.forename: Elif Çiğdem
authors.initials: EÇ
authors.lastname: Kaspar
authors.affiliation: Department of Nephrology, Yeditepe University Hospital, Istanbul, Turkey.
authors.forename: Gülçin
authors.initials: G
authors.lastname: Kantarcı
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D002318:Cardiovascular Diseases / Q000453:epidemiology; D015897:Comorbidity; D005260:Female; D006801:Humans; D053208:Kaplan-Meier Estimate; D007677:Kidney Function Tests; D008297:Male; D009735:Nursing Homes; D015995:Prevalence; D011446:Prospective Studies; D012044:Regression Analysis; D051436:Renal Insufficiency, Chronic / Q000453:epidemiology* / Q000401:mortality; D012307:Risk Factors; D014421:Turkey
keywords: chronic kidney disease; mortality; nursing home resident; prevalence