Showtanapanich Piboon, Pathonsmith Chadawan, Sri-On Jiraporn, Jatutain Appasornsawan, Ngamvichchukorn Tanun
Department of Internal Medicine, Navamindradhiraj University, Bangkok, Thailand.
Department of Emergency Medicine, Navamindradhiraj University, Bangkok, Thailand.
Int J Nephrol Renovasc Dis. 2025 Aug 21;18:229-242. doi: 10.2147/IJNRD.S532499. eCollection 2025.
Residual kidney function (RKF) plays a crucial role in maintaining biochemical balance in hemodialysis patients. Frailty, commonly observed in end-stage renal disease (ESRD) patients, is associated with metabolic derangements, inflammation, and fluid overload. However, the relationship between RKF and frailty in this population remains unclear.
This study aimed to investigate the association between RKF and frailty in ESRD patients undergoing hemodialysis. Secondary objectives included assessing the prevalence of frailty and sarcopenia, and identifying clinical correlates.
A cross-sectional study was conducted involving 110 adult ESRD patients undergoing maintenance hemodialysis for ≥6 months at an urban teaching hospital in Bangkok, Thailand between October 2023 and February 2024. RKF was assessed by 24-hour urine volume, with <100 mL defined as absent RKF. Frailty was evaluated using the Thai version of the FRAIL scale, and sarcopenia was diagnosed based on the 2019 Asian Working Group for Sarcopenia (AWGS) criteria. Demographic, clinical, and laboratory data were analyzed using chi-squared tests, logistic regression, and multivariable models.
Among 110 participants, 78 (70.91%) had no RKF. Frailty prevalence was 13.64%, and sarcopenia prevalence was 65.45%. Frailty was associated with a history of cerebrovascular accident [adjusted odds ratio (OR) 10.303; P = 0.036] and lower total iron-binding capacity (TIBC) (adjusted OR 0.972; P = 0.047). Sarcopenia was linked to advanced age (adjusted OR 1.054; P = 0.020) and lower Kt/V values (adjusted OR 0.417; P = 0.002). RKF was not significantly associated with frailty.
While RKF was not directly associated with frailty, this study highlights other significant factors, such as cerebrovascular accidents and low TIBC, contributing to frailty and advanced age associated with sarcopenia. These findings emphasize the need for comprehensive frailty screening and tailored interventions to improve outcomes in ESRD patients.
残余肾功能（RKF）在维持血液透析患者的生化平衡中起着关键作用。衰弱在终末期肾病（ESRD）患者中普遍存在，与代谢紊乱、炎症和液体过载有关。然而，该人群中RKF与衰弱之间的关系仍不清楚。
本研究旨在调查接受血液透析的ESRD患者中RKF与衰弱之间的关联。次要目标包括评估衰弱和肌肉减少症的患病率，并确定临床相关因素。
于2023年10月至2024年2月在泰国曼谷的一家城市教学医院对110名接受维持性血液透析≥6个月的成年ESRD患者进行了一项横断面研究。通过24小时尿量评估RKF，<100 mL定义为无RKF。使用泰国版FRAIL量表评估衰弱情况，并根据2019年亚洲肌肉减少症工作组（AWGS）标准诊断肌肉减少症。使用卡方检验、逻辑回归和多变量模型分析人口统计学、临床和实验室数据。
110名参与者中，78人（70.91%）无RKF。衰弱患病率为13.64%，肌肉减少症患病率为65.45%。衰弱与脑血管意外病史[调整后的优势比（OR）10.303；P = 0.036]和较低的总铁结合力（TIBC）（调整后的OR 0.972；P = 0.047）相关。肌肉减少症与高龄（调整后的OR 1.054；P = 0.020）和较低的Kt/V值（调整后的OR 0.417；P = 0.002）有关。RKF与衰弱无显著关联。
虽然RKF与衰弱无直接关联，但本研究突出了其他重要因素，如脑血管意外和低TIBC，这些因素导致了与肌肉减少症相关的衰弱和高龄。这些发现强调了对ESRD患者进行全面衰弱筛查和量身定制干预措施以改善预后的必要性。
