Division of Nephrology, Department of Medicine, Jinan University First Affiliated Hospital, Guangzhou, Guangdong, China.
Division of Nephrology, Department of Medicine, Shangrao People's Hospital, Shangrao, Jiangxi, China.
BMJ Open. 2022 Mar 16;12(3):e054177. doi: 10.1136/bmjopen-2021-054177.
Frailty has been extensively studied in the general population. However, there is little information on frailty among patients undergoing haemodialysis (HD) in China. This study analysed the prevalence and associated factors of frailty among Southern Chinese Han patients on HD.
Observational cross-sectional study.
Three HD centres in Southern China.
Three hundred patients who underwent regular HD between June 2019 and October 2019.
Frailty was assessed using the Tilburg indicator of frailty (TFI) questionnaire, and the psychological status of the respondents was evaluated by the Self-Rating Depression Scale (SDS) and the Self-Rating Anxiety Scale (SAS).
Seventy-five per cent of participants were in the frailty group, and the TFI score of HD patients was 6.89±2.87, with 8.15±2.06 in the frailty group and 2.87±1.31 in the non-frailty group. Frailty patients had higher SDS and SAS scores, and were more likely to suffer depression and anxiety than non-frailty patients. Multivariate logistic regression analysis excluding depression and anxiety showed that age, Charlson Comorbidity Index (excluding end-stage renal disease), a nuclear family (compared with living alone), and albumin were independently associated with frailty (all p<0.05). In the model including depression and anxiety, age, diabetes mellitus, living as a couple (compared with living alone), a nuclear family (compared with living alone), an extended family (compared with living alone), low phosphorus, depression and anxiety were associated with frailty by multivariate logistic regression analysis (all p<0.05).
Approximately three-quarters of patients with HD in Southern China are frail, often accompanied with depression and anxiety. Age, diabetes mellitus, family structure, phosphorus, depression and anxiety were associated with frailty.
衰弱已在普通人群中得到广泛研究。然而，关于中国血液透析（HD）患者衰弱的信息很少。本研究分析了中国南方汉族 HD 患者衰弱的患病率及相关因素。
观察性横断面研究。
中国南方的 3 个 HD 中心。
2019 年 6 月至 2019 年 10 月期间接受常规 HD 的 300 名患者。
使用蒂尔堡衰弱指数（TFI）问卷评估衰弱，通过自评抑郁量表（SDS）和自评焦虑量表（SAS）评估受访者的心理状态。
75%的参与者属于衰弱组，HD 患者的 TFI 评分为 6.89±2.87，衰弱组为 8.15±2.06，非衰弱组为 2.87±1.31。衰弱患者的 SDS 和 SAS 评分较高，抑郁和焦虑的发生率高于非衰弱患者。排除抑郁和焦虑的多变量逻辑回归分析表明，年龄、Charlson 合并症指数（不包括终末期肾病）、核心家庭（与独居相比）和白蛋白与衰弱独立相关（均 p<0.05）。在包括抑郁和焦虑的模型中，年龄、糖尿病、夫妻同住（与独居相比）、核心家庭（与独居相比）、大家庭（与独居相比）、低磷、抑郁和焦虑与衰弱通过多变量逻辑回归分析相关（均 p<0.05）。
中国南方 HD 患者中约有四分之三存在衰弱，常伴有抑郁和焦虑。年龄、糖尿病、家庭结构、磷、抑郁和焦虑与衰弱有关。
