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Submitted: 23 Jan 2021
Accepted: 17 Apr 2021
ePublished: 18 May 2021
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J Renal Endocrinol. 2021;7(1): e13.
  Abstract View: 61
  PDF Download: 24

Original Article

Frailty at the beginning of dialysis; is it a prognostic factor?

Santiago Silva 1 * ORCID logo, Cristina Milano 1 ORCID logo, Gonzalo García 1 ORCID logo, Anabel Abib 1 ORCID logo, Carlos Díaz 1 ORCID logo, Gustavo Laham 1 ORCID logo

1 Department of Internal Medicine, Neprhology Section, Centro de Educación Medica e Investigaciones Clinícas (CEMIC), Buenos Aires, Argentina
*Corresponding Author: Santiago Silva, Email: sdst1986@gmail.com, sasilva @cemic.edu.ar

Abstract

Introduction: Frailty (F) refers to the cumulative organic damage caused by aging, as a consequence of a diminished physiological reserve. Frailty’s prevalence is 73% in dialysis.

Objectives: Our aim was to identify the prevalence of F in patients starting hemodialysis (HD) or hemodiafiltration online (HDF) treatment. To asses change in frailty during a six-month period of dialysis Patients and Methods: This prospective cohort study evaluated 67 incident patient starting-HD or HDF at one year, with a follow-up period of at least six months. The frailty was assessed by the Fried frailty method. According to this test, we divided the population in two groups: Pre-frail (0-2) and frail (3-5).

Results: Mean age was 64 years, 64% were male and 92% were treated with HD. A total of 35.8% of the patients were admitted to dialysis with a prosthetic or native fistula. The prevalence of F at the beginning of dialysis was 65.7%. The mean value of Charlson index (CHI) was 5.2 ± 2. There was a significant correlation between CHI and frailty test (P<0.0001). Basal F score (n=67) improved after 6 month (n=52): 3 (2-4) versus1 (1-2) (P<0.0001). Hematocrit (28 versus 32% P=0.05) and calcium levels (8.6 and 8.9 mg/dL, P<0.002) also increased after sixth-month. Global mortality was 7.5%. In the multivariate analysis CHI (P<0.001) and albumin (P=0.003) were frailty predictors.

Conclusion: The prevalence of F in patients who start dialysis therapy is high. There was an improvement in F score after six-month of dialysis treatment. Patients with higher F score had higher mortality with higher CHI

Keywords: Dialysis, Sarcopenia, End-stage chronic renal disease
Citation: Silva S, Milano C, García G, Abib A, Díaz C, Laham G. Frailty at the beginning of dialysis; is it a prognostic factor? J Renal Endocrinol. 2021;7:e13.
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