Division of Nephrology and Hypertension, Los Angeles Biomedical Research Institute at Harbor-UCLA Medical Center, Torrance, California 90502, USA.
J Am Soc Nephrol. 2013 Feb;24(3):337-51. doi: 10.1681/ASN.2012010047. Epub 2012 Dec 20.
Older people constitute an increasingly greater proportion of patients with advanced CKD, including those patients undergoing maintenance dialysis treatment. Frailty is a biologic syndrome of decreased reserve and resistance to stressors that results from cumulative declines across multiple physiologic systems and causes vulnerability to adverse outcomes. Frailty is common in elderly CKD patients, and it may be associated with protein-energy wasting (PEW), sarcopenia, dynapenia, and other complications of CKD. Causes of frailty with or without PEW in the elderly with CKD can be classified into three categories: causes primarily caused by aging per se, advanced CKD per se, or a combination of both conditions. Frailty and PEW in elderly CKD patients are associated with impaired physical performance, disability, poorer quality of life, and reduced survival. Prevention and treatment of these conditions in the elderly CKD patients often require a multifaceted approach. Here, we examine the causes and consequences of these conditions and examine the interplay between frailty and PEW in elderly CKD patients.
老年人在患有晚期慢性肾脏病（CKD）的患者中所占比例越来越大，包括接受维持性透析治疗的患者。衰弱是一种生物综合征，表现为多个生理系统的储备和对压力源的抵抗力下降，导致对不良后果的脆弱性。衰弱在老年 CKD 患者中很常见，它可能与蛋白质-能量消耗（PEW）、肌肉减少症、动力不足和 CKD 的其他并发症有关。伴有或不伴有 PEW 的老年 CKD 患者的衰弱原因可分为三类：主要由衰老本身引起的原因、晚期 CKD 本身引起的原因或这两种情况的组合。老年 CKD 患者的衰弱和 PEW 与身体机能下降、残疾、生活质量较差和生存率降低有关。老年 CKD 患者这些情况的预防和治疗通常需要多方面的方法。在这里，我们研究了这些情况的原因和后果，并研究了老年 CKD 患者衰弱和 PEW 之间的相互作用。
