Get Up & Go: Exercise Interventions for Functional Decline and Nephrology Referrals for CKD


Andre Maddison, fellow in general internal medicine at Western University, is hosting this week’s episode on The Rounds Table alongside Erin Spicer, general internist also at Western University. Together they are covering the effect of an exercise intervention on functional decline in very elderly patients and the mortality benefit associated with outpatient nephrology referrals in patients with chronic kidney disease.

In hospital lack of mobility, sleep deprivation, and poor nutrition can increase frailty and lead to re-admission.  Erin shares an article in which an in-hospital purposeful multi-component exercise intervention aimed at providing moderate intensity exercise was introduced for elderly patients admitted to an acute care of the elderly unit.  This was compared to usual care in terms of the improvement of functional capacity.

Canadian and international guidelines suggest nephrology referral for patients with stage 4 chronic kidney disease.  Andre shares a Canadian article on patients with stage 4 chronic kidney disease who were referred to an outpatient nephrologist.  He covers the effect on all-cause mortality and the patients in which this type of referral may yield most benefit.

Finally, The Good Stuff segment. Erin shares an article on the effect of a campaign in England called ‘End PJ Paralysis’ on patient outcomes.  Andre tells listeners about golf habits among surgical and medical specialties.

Like what you hear?  Rate us on iTunes!  Chat with us on Twitter at @roundstable and tweet at Andre Maddison @MaddisonAndre and Erin Spicer @ErinSpicer4.

Interested in helping us evaluate our podcast episodes? We’re currently recruiting a panel of residents to serve as regular reviewers for the show. If you’re interested, email wkwong@qmed.ca.

The Papers

1. In-hospital exercise intervention: https://jamanetwork.com/journals/jamainternalmedicine/fullarticle/2714300

2. Nephro consultation in CKD: http://www.cmaj.ca/content/191/10/E274

Good Stuff

1. Pyjamas: https://picardonhealth.tumblr.com/post/183749256859/why-pyjamas-can-impede-healing-in-hospital

2. Golf habits: https://www.bmj.com/content/363/bmj.k4859

Music Credits

The Rounds Table Theme Music by Brendan Quinn, Creative Director and Composer, Vapor RMW

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