Frailty, Cognitive Function and Health-related Quality of Life in Older Adults With Advanced Chronic Kidney Disease.

This observational study explores the impact of cognitive impairment and frailty in older adults with advanced chronic kidney disease ].The main question[s] it aims to answer are:What determines the time to initiate dialysis? Cognitive impairment or frailty?What does predict the time to death? Presence of frailty or cognitive impairment?What does correlate strongly with time-low health-related quality of life? frailty or cognitive impairment?

Inclusion Criteria:Patients age 65 years or older.CKD stage 4 and 5 who were identified by two consecutive measurements of estimated glomerular filtration rate (eGFR) <60 mL/min/1.73 m2 separated by more than 3 months.Exclusion Criteria:Patients younger than 65 years old.Chronic kidney disease stages 1,2, and 3.Dialysis dependenceHistory of kidney transplantation.Initial visit with the health care provider.Recent acute kidney injury.Patients who had been hospitalized for more than 2 months before the visit (because long hospitalization might affect the degree of frailty)Patients with myocardial infarction and cerebrovascular accident 3 months before the assessmentPatients who are blind or with limb amputation.Patients who refuse to participate.