[Prevalence of frailty in patients in chronic kidney disease on conservative treatment and on dialysis]

Abstract

Introduction: Frailty is a physiological vulnerability status of the patient which is associated with the increased number of hospitalization and death.

Objectives: To evaluate the prevalence of frailty and its associated factors in patients with chronic kidney disease (CKD) on conservative treatment (CT), hemodialysis (HD) and peritoneal dialysis (PD).

Methods: Frailty was assessed in 146 patients (86 CT, 37 HD and 23 PD) and characterized as muscle weakness and exhaustion--by the physical aspect and vitality domains, respectively, evaluated in the SF-36 quality of life instrument; physical inactivity--if he or she answered "never" or "hardly ever" when asked about physical activity; and as unintentional weight loss (> 4.5 kg per year). Patients were divided into three groups: non-fragile (NF), pre-fragile (PF) and fragile (F). The demographic, clinical and laboratory data were extracted from patient charts.

Results: Frailty was diagnosed in 36% of patients on CT, 37.8% in HD and 47.8% in PD. It was characterized in 36.8% of patients aged between 20 and 40 years and 40.3% of those between 41 and 60 years. Frailty was significantly associated with the use of vitamin D (r = 0.16; p = 0.03), hemoglobin (r = -0.14; p = - 0.02) and intact parathyroid hormone (r = 0.16; p = 0.03).

Conclusions: Frailty is common among patients with CKD on conservative treatment and dialysis, even in those who are not elderly. In the patients studied, the phenotype of frailty was associated with no usage of vitamin D, lower serum levels of hemoglobin and higher levels of parathyroid hormone.