Kennard Alice L, Glasgow Nicholas J, Rainsford Suzanne E, Talaulikar Girish S
Department of Renal Medicine, Canberra Health Services, Australian Capital Territory, Australia.
Australian National University, Canberra, Australian Capital Territory, Australia.
Kidney Int Rep. 2023 Dec 30;9(4):791-806. doi: 10.1016/j.ekir.2023.12.022. eCollection 2024 Apr.
Frailty is a multidimensional clinical syndrome characterized by low physical activity, reduced strength, accumulation of multiorgan deficits, decreased physiological reserve, and vulnerability to stressors. Frailty has key social, psychological, and cognitive implications. Frailty is accelerated by uremia, leading to a high prevalence of frailty in patients with advanced chronic kidney disease (CKD) and end-stage kidney disease (ESKD) as well as contributing to adverse outcomes in this patient population. Frailty assessment is not routine in patients with CKD; however, a number of validated clinical assessment tools can assist in prognostication. Frailty assessment in nephrology populations supports shared decision-making and advanced communication and should inform key medical transitions. Frailty screening and interventions in CKD or ESKD are a developing research priority with a rapidly expanding literature base.
衰弱是一种多维度的临床综合征，其特征为身体活动减少、力量下降、多器官功能缺陷累积、生理储备降低以及对应激源的易感性。衰弱具有关键的社会、心理和认知影响。尿毒症会加速衰弱，导致晚期慢性肾脏病（CKD）和终末期肾脏病（ESKD）患者中衰弱的高患病率，并导致该患者群体出现不良结局。在CKD患者中，衰弱评估并非常规操作；然而，一些经过验证的临床评估工具可有助于预后判断。肾脏病群体中的衰弱评估有助于共同决策和深入沟通，并应为关键的医疗转变提供信息。CKD或ESKD中的衰弱筛查和干预是一个不断发展的研究重点，相关文献基础正在迅速扩大。
