The Center of Gerontology and Geriatrics, West China Hospital, Sichuan University, Chengdu, 610041, Sichuan, People's Republic of China.
National Clinical Research Center for Geriatrics, Chengdu, 610041, Sichuan, People's Republic of China.
Int Urol Nephrol. 2020 Jan;52(1):115-120. doi: 10.1007/s11255-019-02310-2. Epub 2019 Oct 23.
Coexistence of frailty and hemodialysis is related to higher risk of hospitalization, falls and mortality. Given the potential reversibility of frailty, reaching the epidemiology of frailty in hemodialysis is of great importance. However, estimates of the prevalence of frailty in patients on hemodialysis vary widely. We tried to synthesize the existing body of literature on the prevalence of frailty in patients on hemodialysis.
We searched Pubmed, Embase, Web of Science and Cochrane for studies of the prevalence in patients on hemodialysis. The prevalence of frailty was synthesized across eligible studies using a random-effects model. We explored potential origin of heterogeneity in the estimates by meta-regression analysis.
Prevalence range from 6.0 to 82.0% and the pooled prevalence of frailty in patients on dialysis was 34.3% (95% confidence interval (CI) 24.5-44.1%; z = 6.87; p = 0.00). The pooled estimates of prevalence for patients aged < 55, 55-65, and ≥ 65 were 56.0% (95% CI 28.9-83.2%; z = 4.04; p = 0.00), 32.3% (95% CI 22.9-41.7%; z = 6.74; p = 0.00), and 20.3% (95% CI 7.9-32.8%; z = 3.2; p = 0.00), respectively. There were no significant relationships between frailty in hemodialysis and factors such as years of publication, sample size (continuous), sample size(> 500 vs ≤ 500), diagnostic method (the Fried Frailty vs other), country (Europe & USA vs Asia) and duration of hemodialysis.
Frailty influences almost three in ten patients on hemodialysis. Understanding the underlying pathophysiology mechanisms and weakening the impacts of frailty in patients on hemodialysis are called on to action in the future work.
虚弱与血液透析并存与更高的住院风险、跌倒和死亡率相关。鉴于虚弱具有潜在的可逆转性，了解血液透析患者的虚弱流行病学具有重要意义。然而，血液透析患者虚弱的患病率估计值差异很大。我们试图综合现有的关于血液透析患者虚弱患病率的文献。
我们在 Pubmed、Embase、Web of Science 和 Cochrane 中检索了关于血液透析患者患病率的研究。使用随机效应模型对符合条件的研究进行了虚弱患病率的综合评估。我们通过元回归分析探索了估计值中潜在的异质性来源。
患病率范围为 6.0%至 82.0%，透析患者的虚弱总体患病率为 34.3%（95%置信区间 24.5%-44.1%；z=6.87；p=0.00）。年龄<55 岁、55-65 岁和≥65 岁的患者的患病率估计值分别为 56.0%（95%置信区间 28.9%-83.2%；z=4.04；p=0.00）、32.3%（95%置信区间 22.9%-41.7%；z=6.74；p=0.00）和 20.3%（95%置信区间 7.9%-32.8%；z=3.2；p=0.00）。血液透析中的虚弱与发表年份、样本量（连续）、样本量（>500 与≤500）、诊断方法（弗里德衰弱与其他）、国家（欧洲和美国与亚洲）以及血液透析时间等因素之间没有显著关系。
虚弱影响了近十分之三的血液透析患者。未来的工作需要深入了解其潜在的病理生理学机制，并减轻血液透析患者虚弱的影响。
