Describe the prevalence of frailtyin patients with advanced chronic kidney disease (CKD) and those undergoing haemodialysis (HD). 

 

The European Renal Best Practice Group endorses the assessment of functional status and frailty in patients with CKD and those undergoing HD. Though several tools exist, there is no current consensus on the most appropriate tools to implement in practice. 

 

This prospective single-centre, observational cohort study enrolled patients with advanced CKD (GFR<20ml/min) or those undergoing HD with opt-out consent model. Participants were assessed for Fried frailty phenotype during routine outpatient clinic. PearsonChi-squared and Wilcoxon-rank-summ testing examined population differences. 

 

147 CKD and 107 HD participants were recruited. Median age 70 years (IQR 56-79), 62% identifying as male. There was no statistically significant difference in age or sex profile among CKD or HD participants (p=0.65, p=0.41, respectively). Within the entire cohort, unintentional weight loss was evident in 18.5%, 35.4% reported inactivity, 46.5% reported exhaustion, 59.1% had slow walk speed and 64.6% demonstrated poor grip-strength. There was no statistically significant differences in any of these domains between CKD and HD participants (PearsonChi2=1.89, p=0.17, PearsonChi2=0.26, p=0.61, PearsonChi2=0.89, p=0.35, PearsonChi2=0.68, p=0.41, PearsonChi2=0.00, p=0.98, respectively). In this cohort, 43.3% of participants had Fried phenotype frailty; an additional 25.6% were prefrail. There was no difference in frailty prevalence rates between CKD and HD participants (PearsonChi2=0.23, p=0.89). 

 

Fried Frailty phenotype is highly prevalent in both HD and advanced CKD, reflecting high health care resource utilisation. Exploring effective and acceptable frailty interventions is warranted with opportunity to offer prehabilitation before the introduction of HD to optimise outcomes.


Alice L Kennard1,2, Suzanne Rainsford1, Kelly Hamilton2, Nicholas Glasgow1, Kate Pumpa3,4, Angela Douglas4, Girish S Talaulikar1,2
 
 

1.     College of Health and Medicine, The Australian National University, 2601

2.     Department of Renal Medicine, Canberra Health Services, Garran, 2605 

3.     School of Public Health, Physiotherapy and Sports Science, University College Dublin, Ireland 

4.     Discipline of Sport and Exercise Science, Faculty of Health, University of Canberra, 2617