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Is Frailty a Modifiable Risk Factor of Future Adverse Outcomes in Elderly Patients with Incident End-Stage Renal Disease?
Lee, Sung Woo; Lee, Anna; Yu, Mi Yeon; Kim, Sun Wook; Kim, Kwang Il; Na, Ki Young; Chae, Dong Wan; Kim, Cheol Ho; Chin, Ho Jun.
Afiliación
  • Lee SW; Department of Internal Medicine, Seoul National University Postgraduate School, Seoul, Korea.
  • Lee A; Department of Internal Medicine, Eulji General Hospital, Seoul, Korea.
  • Yu MY; Department of Internal Medicine, Seoul National University Bundang Hospital, Seongnam, Korea.
  • Kim SW; Department of Internal Medicine, Seoul National University Hospital, Seoul, Korea.
  • Kim KI; Department of Internal Medicine, Seoul National University Bundang Hospital, Seongnam, Korea.
  • Na KY; Department of Internal Medicine, Seoul National University Bundang Hospital, Seongnam, Korea.
  • Chae DW; Department of Internal Medicine, Seoul National University College of Medicine, Seoul, Korea.
  • Kim CH; Department of Internal Medicine, Seoul National University Postgraduate School, Seoul, Korea.
  • Chin HJ; Department of Internal Medicine, Seoul National University Bundang Hospital, Seongnam, Korea.
J Korean Med Sci ; 32(11): 1800-1806, 2017 Nov.
Article en En | MEDLINE | ID: mdl-28960032
ABSTRACT
Little is known about the clinical significance of frailty and changes of frailty after dialysis initiation in elderly patients with end-stage renal disease (ESRD). We prospectively enrolled 46 elderly patients with incident ESRD at a dialysis center of a tertiary hospital between May 2013 and March 2015. Frailty was assessed by using a comprehensive geriatric assessment protocol and defined as a multidimensional frailty score of ≥ 10. The main outcome was the composite of all-cause death or cardiovascular hospitalization, as determined in June 2016. The median age of the 46 participants was 71.5 years, and 63.0% of them were men. During the median 17.7 months follow-up, the rate of composite outcome was 17.4%. In multivariate logistic regression analysis, after adjusting for age, sex, diabetes, body mass index (BMI), and time of predialytic nephrologic care, female sex, and increased BMI were associated with increased and decreased odds of frailty, respectively. In multivariate Cox proportional hazards analysis, after adjusting for age, sex, diabetes, BMI, and time of predialytic nephrologic care, frailty was significantly associated with the composite adverse outcome. In repeated frailty assessments, the multidimensional frailty score significantly improved 12 months after the initiation of dialysis, which largely relied on improved nutrition. Therefore, frailty needs to be assessed for risk stratification in elderly patients with incident ESRD.
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Texto completo: 1 Colección: 01-internacional Banco de datos: MEDLINE Asunto principal: Fallo Renal Crónico Tipo de estudio: Etiology_studies / Guideline / Observational_studies / Prognostic_studies / Risk_factors_studies Límite: Aged / Female / Humans / Male Idioma: En Revista: J Korean Med Sci Asunto de la revista: MEDICINA Año: 2017 Tipo del documento: Article

Texto completo: 1 Colección: 01-internacional Banco de datos: MEDLINE Asunto principal: Fallo Renal Crónico Tipo de estudio: Etiology_studies / Guideline / Observational_studies / Prognostic_studies / Risk_factors_studies Límite: Aged / Female / Humans / Male Idioma: En Revista: J Korean Med Sci Asunto de la revista: MEDICINA Año: 2017 Tipo del documento: Article