Recent Advances Of Sarcopenia And Frailty In Ckd

This book highlights recent advances in our understanding of sarcopenia and frailty in CKD. The prevalence of sarcopenia and frailty increases substantially as CKD progresses, and experimental studies have demonstrated the pivotal role of accumulated uremic toxin in the development of muscle wasting. Further, sarcopenia and frailty are associated with falls, bone fractures, cognitive impairment, and poor survival prognoses, especially in elderly CKD patients. The syndromes are also related to the risk of end-stage kidney disease. This book provides readers with a deeper understanding of the prevention and management of sarcopenia and frailty in CKD patients to improve their renal and overall health, and suggests directions for future basic and clinical research.

This open access book aims to provide a comprehensive but practical overview of the knowledge required for the assessment and management of the older adult with or at risk of fragility fracture. It considers this from the perspectives of all of the settings in which this group of patients receive nursing care. Globally, a fragility fracture is estimated to occur every 3 seconds. This amounts to 25 000 fractures per day or 9 million per year. The financial costs are reported to be: 32 billion EUR per year in Europe and 20 billon USD in the United States. As the population of China ages, the cost of hip fracture care there is likely to reach 1.25 billion USD by 2020 and 265 billion by 2050 (International Osteoporosis Foundation 2016). Consequently, the need for nursing for patients with fragility fracture across the world is immense. Fragility fracture is one of the foremost challenges for health care providers, and the impact of each one of those expected 9 million hip fractures is significant pain, disability, reduced quality of life, loss of independence and decreased life expectancy. There is a need for coordinated, multi-disciplinary models of care for secondary fracture prevention based on the increasing evidence that such models make a difference. There is also a need to promote and facilitate high quality, evidence-based effective care to those who suffer a fragility fracture with a focus on the best outcomes for recovery, rehabilitation and secondary prevention of further fracture. The care community has to understand better the experience of fragility fracture from the perspective of the patient so that direct improvements in care can be based on the perspectives of the users. This book supports these needs by providing a comprehensive approach to nursing practice in fragility fracture care.

Frailty is considered a multisystem impairment that makes an individual vulnerable to external or internal stressors. Sarcopenia, the age-dependent loss of muscle mass and function, is proposed as the biological substrate and the pathway whereby the consequences of physical frailty develop. These syndromes are associated with a negative impact in quality of life and can lead to the occurrence of disability, institutionalization, and even mortality. The book focuses upon all the related aspects of frailty and sarcopenia and the new advancements in the related treatments including complex issues and research. It includes high-quality chapters in all related aspects for the syndromes of sarcopenia and frailty, which adversely affect the function and overall effectiveness of the musculoskeletal system and interventions to promote rehabilitation.

The number of dialysis patients, and their ages, continues to increase globally. This creates major issues such as rising medical costs in an aging population, how to best manage end-of-life care, and how to train the various practitioners involved in dialysis care. After the US and China, Japan occupies 3rd place with regard to the number of dialysis patients and is also widely regarded as a world leader in dialysis. This book contains selected articles – organized into 4 chapters - that discuss recent advances in dialysis therapy in Japan. Chapter 1 presents insights into causes, risk factors, disease associations, and possible implications for management of dialysis patients. Chapter 2 examines recent progress in hemodialysis treatment, and chapter 3 focuses on developments in peritoneal dialysis. The final chapter concentrates on recent advances in apheresis and current trends in practice, among other topics. This book is aimed at nephrologists, physicians, urologists, nurses, clinical engineers, pharmacists, and nutritionists. It is a significant contribution to furthering the progress of dialysis therapy worldwide.

This book gives an update on the management of dysphagia due to a variety of disorders. Chapters address management of dysphagia due to corrosive ingestion and following anterior cervical surgery, nutritional, endoscopic, and surgical management of dysphagia, the role of surgery in patients with advanced achalasia, dysphagia in patients with head and neck cancer, and lipofilling and oral neuromuscular treatment.

Malnutrition is becoming a more prominent health problem, with an increasing number of elderly CKD patients being put on dialysis. In addition, the presence of inflammation, sarcopenia/frailty, diabetes, and CVD is a definite and independent risk factor associated with higher mortality in this population. Although the restriction of protein intake has been recommended to protect eGFR decline, hyperphosphatemia, and hyperkalemia in CKD patients, it might accelerate the loss of skeletal muscle and adipose mass, leading to a poor prognosis. Therefore, flexible responses are considered regarding whether protein restriction should be continued or loosened in pre-dialysis CKD patients. In undernourished elderly patients undergoing hemodialysis, sufficient calorie/protein intake is necessary to counteract the development of sarcopenia/frailty. It is expected that the application of new drugs including phosphate binders and potassium chelators may achieve both a high enough intake and balanced levels of phosphate and potassium. Furthermore, the improvement of deficient micronutrients and poor appetite is also necessary. Comprehensive care is essential for the wellbeing of elderly patients undergoing hemodialysis. The topicof this Special Issue is "Extension of Healthy Life Span of Dialysis Patients in the Era of a 100-Year Life".

This open access book aims to primarily support nurses as leaders and champions of multimodal, Interdisciplinary nutrition care for older adults. A structured approach to fundamentals of nutrition care across Interdisciplinary settings is combined with additional short chapters about special topics in geriatric nutrition. The book is designed to provide highly accessible information on evidence-based management and care for older adults, with a focus on practical guidance and advice across acute, rehabilitation, and primary and secondary malnutrition prevention settings.The cost of malnutrition in England alone has been estimated to be £19.6 billion per year, or more than 15% of the total public expenditure on health and social care. ^65 years). The importance and benefit of specialised nutrition care, delivered by experts in field, is well established for those with complex nutrition care needs. However, despite the substantial adverse impact of malnutrition on patient and healthcare outcomes, specialised management of this condition is often under-resourced, overlooked and under-prioritised by both older adults and their treating teams. As an alternative, timely, efficient, and effective supportive nutrition care opportunities may be appropriately implemented by nurses and non-specialist Interdisciplinary healthcare team members, working together with nutrition specialists and the older adults they care for. Practical, low-risk opportunities should be considered across nutrition screening, assessment, intervention, and monitoring domains for many patients with, or at risk of malnutrition. Whilst a variety of team members may contribute to supportive nutrition care, the nursing profession provide a clear focal point. Nurses across diverse settings provide the backbone for Interdisciplinary teamwork and essential patient care. The nursing profession should consequently be considered best placed to administer Interdisciplinary, multimodal nutrition care, wherever specialist nutrition care referrals are unlikely to add value or are simply not available. As such, the book is a valuable resource for all healthcare providers dedicated to working with older patients to improve nutrition care. .

This book offers an up-to-date review on the principles and practice of multidimensional assessment and management of the older individual, which represents the cornerstone of modern clinical practice in the elderly. The early chapters cover the main elements and scope of the comprehensive geriatric approach and explain the pathways of care from screening and case finding through to in-depth assessment and treatment planning. Subsequent chapters review the evidence of how best to apply the multidimensional assessment and management approach in defined healthcare settings and within specific clinical areas, such as cancer and surgery. Finally, the education and training challenges are reviewed and the prospects for future clinical service and research in this important field are examined. The book is very timely given the recent advances in application of this approach, which reflect the growing international realization that older people are “core business” in many clinical areas where the role of specialist geriatric medicine has hitherto been limited. Accordingly, the book will be relevant to a wide range of clinicians. The authorship comprises many of the best known and widely published experts in their respective fields.