Okuyama Michihiro, Takeuchi Hidemi, Uchida Haruhito A, Kakio Yuki, Okuyama Yuka, Umebayashi Ryoko, Wada Kentaro, Sugiyama Hitoshi, Sugimoto Ken, Rakugi Hiromi, Kasahara Shingo, Wada Jun
1 Department of Cardiovascular Surgery, Okayama University Hospital, Okayama, Japan.
2 Department of Nephrology, Rheumatology, Endocrinology and Metabolism, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, Okayama, Japan.
Vascular. 2018 Aug;26(4):425-431. doi: 10.1177/1708538118756690. Epub 2018 Feb 5.
Objectives The clinical condition of frailty is a common problem in the elderly population. However, the relationship between peripheral artery disease and frailty in hemodialysis patients remains unknown. The aim of this study was to identify the relationships between peripheral artery disease and frailty in Japanese chronic hemodialysis patients. Methods A total of 362 chronic hemodialysis patients who regularly visited six institutions were enrolled. To evaluate frailty, the modified Fried's frailty phenotype adjusted for Japanese were used. Peripheral artery disease was defined as ankle-brachial index <0.9. Results Of 362 patients, 62 patients (17.1%) were categorized as peripheral artery disease group and 300 patients (82.9%) as Non-peripheral artery disease group. The prevalence of frailty in the peripheral artery disease group was significantly higher than in the Non-peripheral artery disease group (34% vs. 18%, P = 0.0103). Non-shunt side grip strength was significantly stronger in the Non-peripheral artery disease group (23.6 kg vs. 17.0 kg, P < 0.0001). Thigh circumferences were also significantly larger in the Non-peripheral artery disease group (41.7 cm vs. 39.7 cm, P = 0.0054). A multivariate logistic regression analysis demonstrated that the factors independently associated with peripheral artery disease were as follows: frailty (odds ratio = 2.06, 95% confidence interval 1.09-3.89) and myocardial infarction (odds ratio = 3.74, 95% confidence interval 2.05-6.83). Conclusions It is concluded that peripheral artery disease is closely associated with frailty in hemodialysis patients.
目的 衰弱这一临床状况在老年人群中是一个常见问题。然而，血液透析患者外周动脉疾病与衰弱之间的关系仍不清楚。本研究的目的是确定日本慢性血液透析患者外周动脉疾病与衰弱之间的关系。方法 共纳入了定期前往六个机构就诊的362例慢性血液透析患者。为评估衰弱，采用了针对日本人调整后的改良弗里德衰弱表型。外周动脉疾病定义为踝臂指数<0.9。结果 在362例患者中，62例患者（17.1%）被归类为外周动脉疾病组，300例患者（82.9%）为非外周动脉疾病组。外周动脉疾病组的衰弱患病率显著高于非外周动脉疾病组（34%对18%，P = 0.0103）。非外周动脉疾病组非分流侧握力明显更强（23.6 kg对17.0 kg，P < 0.0001）。非外周动脉疾病组的大腿周长也明显更大（41.7 cm对39.7 cm，P = 0.0054）。多因素逻辑回归分析表明，与外周动脉疾病独立相关的因素如下：衰弱（比值比 = 2.06，95%置信区间1.09 - 3.89）和心肌梗死（比值比 = 3.74，95%置信区间2.05 - 6.83）。结论 得出结论，外周动脉疾病与血液透析患者的衰弱密切相关。
