Lee So-Young, Yang Dong Ho, Hwang Eunah, Kang Seock Hui, Park Sun-Hee, Kim Tae Woo, Lee Duk Hyun, Park Kisoo, Kim Jun Chul
Department of Internal Medicine, Division of Nephrology, CHA Bundang Medical Center, CHA University School of Medicine, Seongnam, South Korea.
Department of Internal Medicine, Division of Nephrology, Keimyung University School of Medicine, Daegu, South Korea.
J Ren Nutr. 2017 Mar;27(2):106-112. doi: 10.1053/j.jrn.2016.11.003. Epub 2017 Jan 4.
To investigate the clinical implications of frailty in chronic kidney disease patients undergoing maintenance hemodialysis and chronic peritoneal dialysis.
In this prospective study, all of the participants completed the Short Form of the Kidney Disease Quality of Life questionnaire, Korean version, to determine their frailty phenotype. We also obtained blood chemistry and demographic data at enrollment. Data regarding the history of hospitalization and death were collected during the follow-up period.
We recruited 1,658 patients (1,255 maintenance hemodialysis and 403 chronic peritoneal dialysis) from multidialysis units (n = 27). We excluded patients who had been hospitalized in the previous 3 months.
Hospitalization and survival rate during study period.
The participants' mean age was 55.2 ± 11.9 years old, and 55.2% were male. Among the participants, 34.8% were rated as frail and 45.7% as prefrail. Multivariate analysis demonstrated significant associations of frailty with age, comorbidity, disability, unemployment, higher body mass index, and a lower educational level. During the follow-up period (median 17.1 months), 608 patients (79 not frail, 250 prefrail, and 279 frail) were hospitalized, and 87 patients (10 not frail, 24 prefrail, and 53 frail) died (P < .001). Frailty was associated with hospitalization (adjusted hazard ratio, 1.80; 95% confidence interval: 1.38-2.36) and mortality (hazard ratio, 2.37, 95% confidence interval: 1.11-5.02).
The frailty phenotype was common even in, prevalent end-stage renal disease patients on dialysis, and was significantly associated with higher rates of hospitalization and mortality.
探讨衰弱在接受维持性血液透析和慢性腹膜透析的慢性肾脏病患者中的临床意义。
在这项前瞻性研究中，所有参与者均完成了韩国版肾脏病生活质量简表，以确定其衰弱表型。我们还在入组时获取了血液生化和人口统计学数据。在随访期间收集了住院史和死亡数据。
我们从27个多透析单位招募了1658例患者（1255例维持性血液透析患者和403例慢性腹膜透析患者）。我们排除了过去3个月内曾住院的患者。
研究期间的住院率和生存率。
参与者的平均年龄为55.2±11.9岁，55.2%为男性。在参与者中，34.8%被评为衰弱，45.7%被评为衰弱前期。多变量分析显示，衰弱与年龄、合并症、残疾、失业、较高的体重指数和较低的教育水平显著相关。在随访期间（中位时间17.1个月），608例患者（79例非衰弱、250例衰弱前期和279例衰弱）住院，87例患者（10例非衰弱、24例衰弱前期和53例衰弱）死亡（P<0.001）。衰弱与住院（调整后的风险比，1.80；95%置信区间：1.38-2.36）和死亡率（风险比，2.37，95%置信区间：1.11-5.02）相关。
即使在接受透析的晚期肾病患者中衰弱表型也很常见，并且与较高的住院率和死亡率显著相关。
