High prevalence of frailty in end-stage renal disease.
High prevalence of frailty in end-stage renal disease.
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DOI：
10.1007/s11255-016-1306-z
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发表时间：
2016-08
影响因子：
2
通讯作者：
van Munster BC
中科院分区：
文献类型：
--
作者：
Drost D;Kalf A;Vogtlander N;van Munster BC
越来越多的老年终末期肾病（ESRD）患者的预后较差，且功能衰退和死亡的风险很高。对于那些无法从透析中受益的患者来说，虚弱似乎是一个很好的预测指标。人群之间不同的患病率可能与所使用的仪器有关。本研究的目的是使用两种不同的经过验证的仪器来测量 ESRD 患者虚弱的患病率。这项横断面研究是在 2013 年 9 月至 2013 年 12 月期间在荷兰阿珀尔多伦的一个透析中心接受血液透析、腹膜透析和透析前护理的患者中进行的，年龄≥18 岁。衰弱程度通过衰弱指数（FI）和衰弱表型（FP）来衡量。 在 95 名 ESRD 参与者（年龄：65.2 岁，SD ± 12.0）中，FI 的虚弱患病率为 36.8%。年龄≥65 岁和<65 岁的参与者的衰弱患病率分别为 43.6% 和 27.5%。女性[比值比 (OR) 3.3，95% 置信区间 (CI) 1.3–8.0] 和 Charlson 合并症指数评分≥5（OR 2.6，95% CI 1.0–6.6）与虚弱相关。与 FP 相比，FI 将不同但重叠的参与者视为虚弱；根据 FI 的数据，62.5% 的虚弱参与者也根据 FP 的数据虚弱。年轻和老年 ESRD 患者虚弱的患病率很高；女性且患有更多合并症与虚弱有关。与身体虚弱评估相比，使用更广泛的虚弱定义（如 FI）可以对 ESRD 患者的患病率进行更高的估计。本文的在线版本 (doi:10.1007/s11255-016-1306-z) 包含补充材料，可供授权用户使用。
Prognosis of the increasing number of elderly patients with end-stage renal disease (ESRD) is poor with high risk of functional decline and mortality. Frailty seems to be a good predictor for those patients that will not benefit from dialysis. Varying prevalences between populations are probably related to the instrument used. The aim of this study was to measure the prevalence of frailty among ESRD patients with two different validated instruments. This cross-sectional study was conducted among patients, aged ≥18 years, receiving hemodialysis, peritoneal dialysis and pre-dialysis care between September 2013 and December 2013 in a single dialysis center in Apeldoorn, the Netherlands. Frailty was measured with the frailty index (FI) and frailty phenotype (FP). Prevalence of frailty by the FI was 36.8 % among 95 participants with ESRD (age: 65.2 years, SD ± 12.0). Frailty prevalence among participants aged ≥65 and <65 years was 43.6 and 27.5 %, respectively. Female sex [odds ratio (OR) 3.3, 95 % confidence interval (CI) 1.3–8.0] and a Charlson comorbidity index score of ≥5 (OR 2.6, 95 % CI 1.0–6.6) were associated with frailty. The FI identified different but overlapping participants as frail compared with the FP; 62.5 % of frail participants according to FI were also frail according to the FP. Prevalence of frailty among young and elderly ESRD patients is high; being female and having more comorbidity was associated with frailty. Use of a broader definition of frailty, like the FI, gives a higher estimation of prevalence among ESRD patients compared with a physical frailty assessment. The online version of this article (doi:10.1007/s11255-016-1306-z) contains supplementary material, which is available to authorized users.