Peripheral artery disease is associated with frailty in chronic hemodialysis patients

Abstract

Objectives The clinical condition of frailty is a common problem in the elderly population. However, the relationship between peripheral artery disease and frailty in hemodialysis patients remains unknown. The aim of this study was to identify the relationships between peripheral artery disease and frailty in Japanese chronic hemodialysis patients. Methods A total of 362 chronic hemodialysis patients who regularly visited six institutions were enrolled. To evaluate frailty, the modified Fried's frailty phenotype adjusted for Japanese were used. Peripheral artery disease was defined as ankle-brachial index <0.9. Results Of 362 patients, 62 patients (17.1%) were categorized as peripheral artery disease group and 300 patients (82.9%) as Non-peripheral artery disease group. The prevalence of frailty in the peripheral artery disease group was significantly higher than in the Non-peripheral artery disease group (34% vs. 18%, P = 0.0103). Non-shunt side grip strength was significantly stronger in the Non-peripheral artery disease group (23.6 kg vs. 17.0 kg, P < 0.0001). Thigh circumferences were also significantly larger in the Non-peripheral artery disease group (41.7 cm vs. 39.7 cm, P = 0.0054). A multivariate logistic regression analysis demonstrated that the factors independently associated with peripheral artery disease were as follows: frailty (odds ratio = 2.06, 95% confidence interval 1.09-3.89) and myocardial infarction (odds ratio = 3.74, 95% confidence interval 2.05-6.83). Conclusions It is concluded that peripheral artery disease is closely associated with frailty in hemodialysis patients.

Diabetic nephropathy is associated with frailty in patients with chronic hemodialysis

“…Regarding the complication of DM, the authors reported that peripheral artery disease was closely associated with frailty in chronic HD patients. 10 It is well known that DM is strongly related to peripheral artery disease. 11,27 As expected, in the present study, the ABI score was lower in the DN group than the Non-DN group.…”

“…The initial exclusion criteria were: (i) patients who refused to participate; (ii) patients who were in a hospital due to accidents or sickness; and (iii) patients who were unable to answer the questionnaire. In addition, the authors excluded participants who did not completely fill in the frailty information, as the authors described previously …”

“…In addition, the authors excluded participants who did not completely fill in the frailty information, as the authors described previously. 5,10 Evaluation of frailty All of the data acquisition was carried out by the attending physicians and medical staff at each institution, and were collected by the Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences for the analyses. Finally, 355 patients treated with HD in the participating centers were assigned into either the patients who developed ESRD caused by DN (DN group) or patients who developed ESRD as a result of other underlying disorders (Non-DN group; Fig.…”

Physical function and physical activity in hemodialysis patients with peripheral artery disease

“…However, the previous study included few patients with severe CKD on hemodialysis. A recent cross‐sectional study in a cohort of patients receiving hemodialysis demonstrated a significant association between PAD and frailty as defined by Fried's frailty phenotype modified for the Japanese population 14 . However, since this previous study examined only the association between PAD and a medical syndrome (i.e., frailty) in which the five components were unclear, detailed data on the relationships between PAD and physical function and physical activity were lacking.…”

“…A recent cross-sectional study in a cohort of patients receiving hemodialysis demonstrated a significant association between PAD and frailty as defined by Fried's frailty phenotype modified for the Japanese population. 14 However, since this previous study examined only the association between PAD and a medical syndrome (i.e., frailty) in which the five components were unclear, detailed data on the relationships between PAD and physical function and physical activity were lacking. For disease management (intervention), it is necessary to clarify not only the medical symptoms but also the relationship with physical functions.…”