Prof. Dr. Gulistan Bahat, Istanbul University, Istanbul Medical School, Department of Internal Medicine, Division of Geriatrics, Capa, 34093, Istanbul, Turkey, Telephone: + 90 212 414 20 00-31478; 33090, Fax:+ 90 212 414 22 48,+ 90 212 532 42 08, e-mail:
J Nutr Health Aging. 2022;26(9):889-895. doi: 10.1007/s12603-022-1839-z.
OBJECTIVES: Frailty is a state of homeostenosis associated with adverse outcomes. Chronic kidney disease (CKD) increases considerably by aging and shares the common risk factors with frailty. We aimed to examine the prevalence and independent associates of frailty status in CKD patients. DESIGN: In this single-centre, cross-sectional study, we used the five-item Fatigue, Resistance, Ambulation, Illnesses and Loss of Weight (FRAIL) scale to evaluate frailty. A binary logistic regression analysis model including the parameters found to have relationship with frailty in univariate analyses was used to detect independent associates of frailty status. Odds ratio (OR) and 95% confidence interval (CI) were given. PARTICIPANTS: Study included 148 patients aged 18-80. Sixty (60) patients were end stage renal disease (ESRD) patients on maintenance hemodialysis (HD) (at least for 3 months) and 88 were stage 3-4 CKD patients. Thirty-seven (37) patients (42%) were eGFR G3a, 31 patients (35.3%) were eGFR G3b and 20 patients (22.7%) were eGFR G4 in stage 3-4 CKD patients. MEASUREMENTS: Demographics, etiology of CKD, comorbidities, regular drugs, dialysis-related and laboratory data were recorded. FRAIL scale was scored as follows; 0=robust, 1-2=prefrail, and ≥3= frail. The frailty status was compared between frail+prefrail group vs robust (non-frail) group. RESULTS: The prevalences of prefrailty and frailty were 68.3% and 3.3% in HD group and 53.4% and zero in stage 3-4 CKD group, respectively (p = 0.025). In the multivariate logistic regression analysis, being in HD group (OR=3.87, 95% CI= 1.06-14.19, p=0.04), older age (OR=1.09, 95% CI= 1.04-1.13) and female sex (OR=9.13, 95%CI= 2.82-29.46) were independent risk factors for frailty (p<0.001, for both). CONCLUSION: Prefrailty and frailty are quite common among HD and CKD stage 3-4 patients. Being an HD patient is an independent risk factor for non-robust (frail or prefrail) status. Our findings point out a remarkably high prevalence of frailty severity (prefrailty/frailty) phenotype among patients with advanced CKD stages.
目的：衰弱是一种与不良结局相关的内稳态状态。随着年龄的增长，慢性肾脏病（CKD）显著增加，并且与衰弱具有共同的危险因素。我们旨在研究 CKD 患者衰弱状态的患病率和独立相关因素。
设计：在这项单中心、横断面研究中，我们使用了五项疲劳、抵抗力、活动能力、疾病和体重减轻（FRAIL）量表来评估衰弱。使用包括单因素分析中与衰弱相关的参数的二元逻辑回归分析模型来检测衰弱状态的独立相关因素。给出比值比（OR）和 95%置信区间（CI）。
参与者：研究包括 148 名年龄在 18-80 岁的患者。60 名患者为终末期肾病（ESRD）患者，正在接受维持性血液透析（HD）治疗（至少 3 个月），88 名患者为 3-4 期 CKD 患者。37 名患者（42%）的 eGFR 为 G3a，31 名患者（35.3%）的 eGFR 为 G3b，20 名患者（22.7%）的 eGFR 为 3-4 期 CKD 患者的 G4。
测量：记录人口统计学、CKD 的病因、合并症、常规药物、透析相关和实验室数据。FRAIL 量表的评分如下：0=强壮，1-2=衰弱前期，≥3=衰弱。比较衰弱+衰弱前期组与强壮（非衰弱）组之间的衰弱状态。
结果：HD 组的衰弱前期和衰弱的患病率分别为 68.3%和 3.3%，3-4 期 CKD 组分别为 53.4%和 0（p=0.025）。在多变量逻辑回归分析中，处于 HD 组（OR=3.87，95%CI=1.06-14.19，p=0.04）、年龄较大（OR=1.09，95%CI=1.04-1.13）和女性（OR=9.13，95%CI=2.82-29.46）是衰弱的独立危险因素（p<0.001，均如此）。
结论：衰弱前期和衰弱在 HD 和 3-4 期 CKD 患者中较为常见。接受 HD 治疗是非强壮（衰弱或衰弱前期）状态的独立危险因素。我们的研究结果表明，晚期 CKD 患者的衰弱严重程度（衰弱前期/衰弱）表型患病率显著较高。
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