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Journal
First Published
30 Mar 2015
Publication timeframe
4 times per year
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English
access type Open Access

The Frailty Phenotype in Hemodialysis Patients and its Association with Biochemical Markers of Mineral Bone Disorder, Inflammation and Nutrition

Published Online: 31 Jul 2021
Page range: -
Received: 19 May 2021
Journal Details
License
Format
Journal
First Published
30 Mar 2015
Publication timeframe
4 times per year
Languages
English
Abstract

Introduction: Frailty is a state of increased vulnerability to physical stressors. It is common in patients with end-stage renal disease (ESRD) who are on hemodialysis (HD).

The aim of this study was to analyze the presence of frailty phenotype among HD patients and to evaluate their interrelationship with different biochemical markers.

Methods: For the frailty assessment the Frailty Phenotype by Fried et al. was used, where frailty was reported if three of the following criteria were met: unintentional weight loss, self-reported exhaustion, weakness, slow walking speed and low physical activity. From 281 HD patients, 126 patients were frail, 58 were pre-frail (two criteria were met) and the rest of the study population were robust (97 patients). BMI was calculated for all patients and venous blood samples were taken to determine laboratory parameters for bone alkaline phosphatase (BAP), phosphate (P), potassium (K), C-reactive protein (CRP) and albumin.

Results: Patients who were on HD longer than 60 months have more characters of frailty. (p=0.019). A statistically significant positive correlations between frailty score and BAP (rho = 0.189; p = 0.001), and CRP (rho = 0.233; p < 0.001) were observed, and significant negative correlations between frailty score and albumin (rho = - 0.218; p < 0.001) and K (rho = - 0.198; p = 0.001).

Conclusions: The associations of frailty with markers of mineral bone disorder, inflammation and nutrition indicate the importance of these parameters in the indirect assessment of the frailty phenotype in HD patients.

Keywords

1. NIXON AC., BAMPOURAS TM., PENDLETON N., WOYWODT A., MITRA S., DHAYGUDE A. Frailty and chronic kidney disease: current evidence and continuing uncertainties. Clin Kidney J. 2018; 11(2): 236–245.Search in Google Scholar

2. JOHANSEN KL., CHERTOW GM., JIN C., KUTNER NG. Significance of frailty among dialysis patients. J Am Soc Nephrol 2007; 18: 2960–2967.Search in Google Scholar

3. JOHANSEN KL., DALRYMPLE LS., DELGADO C., CHERTOW GM., SEGAL MR., CHIANG J., et al. Factors Associated with Frailty and Its Trajectory among Patients on Hemodialysis. Clin J Am Soc Nephrol. 2017; 12(7): 1100–1108.Search in Google Scholar

4. WALSTON JD., BANDEEN-ROCHE K. Frailty: a tale of two concepts. BMC Med 2015; 13: 185.Search in Google Scholar

5. FRIED LP., TANGEN CM., WALSTON J., NEWMAN AB., HIRSCH C., GOTTDIENER J., et al. Frailty in older adults: evidence for a phenotype. J Gerontol A Biol Sci Med Sci 2001; 56(3): 146–56.Search in Google Scholar

6. WORLD HEALTH ORGANIZATION. Obesity: preventing and managing the global epidemic. Geneva: WHO; 1997.Search in Google Scholar

7. MUSSO CG., JAUREGUI JR., NÚÑEZ JFM. Frailty phenotype and chronic kidney disease: a review of the literature. Int Urol Nephrol. 2015;47(11):1801-7.Search in Google Scholar

8. CHOWDHURY R., PEEL NM., KROSCH M., HUBBARD RE. Frailty and chronic kidney disease: A systematic review. Arch Gerontol Geriatr. 2017;68:135-142.Search in Google Scholar

9. TAKEUCHI H., UCHIDA HA., KAKIO Y., OKUYAMA Y., OKUYAMA M., UMEBAYASHI R., et al. The Prevalence of Frailty and its Associated Factors in Japanese Hemodialysis Patients. Aging Dis. 2018; 9(2):192-207.Search in Google Scholar

10. GARCIA-CANTON C., RODENAS A., LOPEZ-APERADOR C., RIVERO Y., ANTON G., MONZON T., et al. Frailty in hemodialysis and prediction of poor short-term outcome: mortality, hospitalization and visits to hospital emergency services. Ren Fail. 2019; 41(1): 567–575.Search in Google Scholar

11. KDOQI. KDOQI clinical practice guideline for vascular access: 2019. [Cited 06 May 2021]. Available from: https://www.ajkd.org/article/S0272-6386(19)31137-0/fulltextSearch in Google Scholar

12. KUNINGAS K, INSTON N. Age is just a number: Is frailty being ignored in vascular access planning for dialysis? J Vasc Access. 2021; 11(2):972-982.Search in Google Scholar

13. RAO N, DUNDON BK, WORTHLEY IM, FAULL JR. The Impact of Arteriovenous Fistulae for Hemodialysis on the Cardiovascular System. Semin Dial 2016; 29(3):214-21.Search in Google Scholar

14. YONEKI K., KITAGAWA J., HOSHI K., HARADA M., WATANABE T., SHIMODA T, et al. Association between frailty and bone loss in patients undergoing maintenance hemodialysis. Bone Miner Metab. 2019 Jan;37(1):81-89.Search in Google Scholar

15. SNEŽANA UNČANIN-MEĐOVIĆ. Hronična bubrežna bolest. In: Senija Rašić. Klinička Nefrologija.Sarajevo: Medicinski fakultet Univerziteta u Sarajevu. 2020; 348-349.Search in Google Scholar

16. LOPEZ-MONTES A, MARTINEZ-VILLAESCUSA M, PEREZ-RODRIGUEZ A, ANDRES-MONPEAN E, MARTINEZ-DIAZ M, MASIA J, GIMENEZ-BACHS JM, et al. Frailty, physical function and affective status in elderly patients on hemodialysis. Arch Gerontol Geriatr. 2020; 87(1):39-76.Search in Google Scholar

17. HENDRA H, VAJGEL G, ANTONELOU M, NERADOVA A, MANSON B, CLARK SG, et al. Identifying prognostic risk factors for poor outcome following COVID-19 disease among in-centre haemodialysis patients: role of inflammation and frailty. J Nephrol. 2021; 9(2):1–9.Search in Google Scholar

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