Frailty in Chinese Peritoneal Dialysis Patients: Prevalence and Prognostic Significance

Abstract

Background/Aims: Previous studies showed that frailty is prevalent in both pre-dialysis and dialysis patients. However, the prevalence and prognostic implication of frailty in Chinese peritoneal dialysis (PD) patients remain unknown. Methods: We used a validated questionnaire to determine the Frailty Score of 193 unselected prevalent PD patients. All patients were then followed for 2 years for their need of hospitalization and mortality. Results: Amongst the 193 patients, 134 (69.4%) met the criteria of being frail. Frailty Score significantly correlated with Charlson's comorbidity score (r = 0.40, p < 0.0001), Malnutrition Inflammation Score (r = 0.59, p < 0.0001), and inversely with Subjective Global Assessment score (r = -0.44, p < 0.0001). Frailty was closely associated with the need of hospitalization. Patients with nil, mild, moderate, and severe frailty required 2.4 ± 6.0, 1.6 ± 1.6, 2.7 ± 2.5, 5.2 ± 4.8 hospital admissions per year, respectively (p < 0.0001), and they stayed in hospital for 6.4 ± 9.2, 5.3 ± 6.2, 10.0 ± 10.4, 12.9 ± 20.1 days per hospital admission, respectively (p < 0.0001). However, Frailty Score was not an independent predictor of patient or technique survival. Conclusions: Frailty is prevalent among Chinese PD patients. Frail PD patients have a high risk of requiring hospitalization and their hospital stay tends to be prolonged. Early identification may allow timely intervention to prevent adverse health outcomes in this group of patients.

Depression and Physical Frailty Have Additive Effect on the Nutritional Status and Clinical Outcome of Chinese Peritoneal Dialysis

“…For example, previous studies found that physical frailty is present in around 35% to 50% of hemodialysis patients [8,32] and over 60% of PD patients [23], which are similar to the prevalence of 62% in our present study. On the other hand, the prevalence of depression and cognitive impairment are considerably lower in our present study than previous ones.…”

“…After informed consent, physical frailty, depressive symptoms and cognitive function were assessed by standard instruments as described previously [23][24][25]. Briefly, frailty was assessed by an in-house Chinese questionnaire that was validated by our group.…”

“…Briefly, frailty was assessed by an in-house Chinese questionnaire that was validated by our group. The frailty questionnaire consists of 30 dichotomous questions that covers various aspects of physical functioning and self-care capability [23]. In this questionnaire, physical frailty was defined as a score of 6 or above [23].…”

Eryptosis (quasi-apoptosis) the human red blood cells. Its role in medicinal therapy

“…Более современные данные, однако, свидетельствуют, что увеличенный эриптоз эритроцитов у пациентов с ХБП способствует восстанавлению продолжительности жизни эритроцитов при кровообращении [24,55,176]. Согласно исследованиям in vitro, уремические токсины, такие как ванадат [109], метилглиоксаль [226], акролеин [22] и сульфат индоксила [117], модифицируют эриптоз.…”

Angiogenesis and Inflammation in Peritoneal Dialysis: The Role of Adipocytes

“…Unfortunately, recurrent peritonitis and progressive peritoneal tissue remodeling, as well as angiogenesis, ultimately leads to utrafiltration failure (UFF), which results in discontinuation of PD therapy. Frail PD patients are more likely to be hospitalized, and they require a long stay for each hospital admission [3]. In developed countries, the proportion of dialysis patients undergoing PD significantly declined in the last 15 years [4].…”