Frailty at the beginning of dialysis; is it a prognostic factor?

Publish Year: 1400
نوع سند: مقاله ژورنالی
زبان: English
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شناسه ملی سند علمی:

JR_JRE-7-1_013

تاریخ نمایه سازی: 30 مرداد 1401

Abstract:

Introduction: Frailty (F) refers to the cumulative organic damage caused by aging, as a consequence of a diminished physiological reserve. Frailty’s prevalence is ۷۳% in dialysis.Objectives: Our aim was to identify the prevalence of F in patients starting hemodialysis (HD) or hemodiafiltration online (HDF) treatment to asses change in frailty during a six-month period of dialysis.Patients and Methods: This prospective cohort study evaluated ۶۷ incident patient starting-HD or HDF at one year, with a follow-up period of at least six months. The frailty was assessed by the Fried frailty method. According to this test, we divided the population in two groups: Pre-frail (۰-۲) and frail (۳-۵).Results: Mean age was ۶۴ years, ۶۴% were male and ۹۲% were treated with HD. A total of ۳۵.۸% of the patients were admitted to dialysis with a prosthetic or native fistula. The prevalence of F at the beginning of dialysis was ۶۵.۷%. The mean value of Charlson index (CHI) was ۵.۲ ± ۲. There was a significant correlation between CHI and frailty test (P < ۰.۰۰۰۱). Basal F score (n=۶۷) improved after ۶ month (n=۵۲): ۳ (۲-۴) versus۱ (۱-۲) (P < ۰.۰۰۰۱). Hematocrit (۲۸ versus ۳۲% P = ۰.۰۵) and calcium levels (۸.۶ and ۸.۹ mg/dL, P < ۰.۰۰۲) also increased after sixth-month. Global mortality was ۷.۵%. In the multivariate analysis CHI (P < ۰.۰۰۱) and albumin (P = ۰.۰۰۳) were frailty predictors.Conclusion: The prevalence of F in patients who start dialysis therapy is high. There was an improvement in F score after six-month of dialysis treatment. Patients with higher F score had higher mortality with higher CHI.

Keywords:

Dialysis , Sarcopenia , End-stage chronic renal disease

Authors

Santiago Silva

Department of Internal Medicine, Neprhology Section, Centro de Educación Medica e Investigaciones Clinícas (CEMIC), Buenos Aires, Argentina

Cristina Milano

Department of Internal Medicine, Neprhology Section, Centro de Educación Medica e Investigaciones Clinícas (CEMIC), Buenos Aires, Argentina

Gonzalo García

Department of Internal Medicine, Neprhology Section, Centro de Educación Medica e Investigaciones Clinícas (CEMIC), Buenos Aires, Argentina

Anabel Abib

Department of Internal Medicine, Neprhology Section, Centro de Educación Medica e Investigaciones Clinícas (CEMIC), Buenos Aires, Argentina

Carlos Díaz

Department of Internal Medicine, Neprhology Section, Centro de Educación Medica e Investigaciones Clinícas (CEMIC), Buenos Aires, Argentina

Gustavo Laham

Department of Internal Medicine, Neprhology Section, Centro de Educación Medica e Investigaciones Clinícas (CEMIC), Buenos Aires, Argentina