Yaxi Zhao1,2, Qinyu Liu3, Jie Ji4. 1. The Center of Gerontology and Geriatrics, West China Hospital, Sichuan University, Chengdu, 610041, Sichuan, People's Republic of China. 2. National Clinical Research Center for Geriatrics, Chengdu, 610041, Sichuan, People's Republic of China. 3. Department of Urology, Institute of Urology (Laboratory of Reconstructive Urology), West China Hospital, Sichuan University, No. 37 Guo Xue Xiang, Chengdu, 610041, Sichuan, People's Republic of China. 4. Department of Hematology and Hematological Research Laboratory, West China Hospital, Sichuan University, Chengdu, Sichuan, 610041, People's Republic of China. jiejscu@163.com.
Abstract
PURPOSE: Coexistence of frailty and hemodialysis is related to higher risk of hospitalization, falls and mortality. Given the potential reversibility of frailty, reaching the epidemiology of frailty in hemodialysis is of great importance. However, estimates of the prevalence of frailty in patients on hemodialysis vary widely. We tried to synthesize the existing body of literature on the prevalence of frailty in patients on hemodialysis. METHODS: We searched Pubmed, Embase, Web of Science and Cochrane for studies of the prevalence in patients on hemodialysis. The prevalence of frailty was synthesized across eligible studies using a random-effects model. We explored potential origin of heterogeneity in the estimates by meta-regression analysis. RESULTS: Prevalence range from 6.0 to 82.0% and the pooled prevalence of frailty in patients on dialysis was 34.3% (95% confidence interval (CI) 24.5-44.1%; z = 6.87; p = 0.00). The pooled estimates of prevalence for patients aged < 55, 55-65, and ≥ 65 were 56.0% (95% CI 28.9-83.2%; z = 4.04; p = 0.00), 32.3% (95% CI 22.9-41.7%; z = 6.74; p = 0.00), and 20.3% (95% CI 7.9-32.8%; z = 3.2; p = 0.00), respectively. There were no significant relationships between frailty in hemodialysis and factors such as years of publication, sample size (continuous), sample size(> 500 vs ≤ 500), diagnostic method (the Fried Frailty vs other), country (Europe & USA vs Asia) and duration of hemodialysis. CONCLUSIONS: Frailty influences almost three in ten patients on hemodialysis. Understanding the underlying pathophysiology mechanisms and weakening the impacts of frailty in patients on hemodialysis are called on to action in the future work.
PURPOSE: Coexistence of frailty and hemodialysis is related to higher risk of hospitalization, falls and mortality. Given the potential reversibility of frailty, reaching the epidemiology of frailty in hemodialysis is of great importance. However, estimates of the prevalence of frailty in patients on hemodialysis vary widely. We tried to synthesize the existing body of literature on the prevalence of frailty in patients on hemodialysis. METHODS: We searched Pubmed, Embase, Web of Science and Cochrane for studies of the prevalence in patients on hemodialysis. The prevalence of frailty was synthesized across eligible studies using a random-effects model. We explored potential origin of heterogeneity in the estimates by meta-regression analysis. RESULTS: Prevalence range from 6.0 to 82.0% and the pooled prevalence of frailty in patients on dialysis was 34.3% (95% confidence interval (CI) 24.5-44.1%; z = 6.87; p = 0.00). The pooled estimates of prevalence for patients aged < 55, 55-65, and ≥ 65 were 56.0% (95% CI 28.9-83.2%; z = 4.04; p = 0.00), 32.3% (95% CI 22.9-41.7%; z = 6.74; p = 0.00), and 20.3% (95% CI 7.9-32.8%; z = 3.2; p = 0.00), respectively. There were no significant relationships between frailty in hemodialysis and factors such as years of publication, sample size (continuous), sample size(> 500 vs ≤ 500), diagnostic method (the Fried Frailty vs other), country (Europe & USA vs Asia) and duration of hemodialysis. CONCLUSIONS: Frailty influences almost three in ten patients on hemodialysis. Understanding the underlying pathophysiology mechanisms and weakening the impacts of frailty in patients on hemodialysis are called on to action in the future work.
Authors: Lesley A Stewart; Mike Clarke; Maroeska Rovers; Richard D Riley; Mark Simmonds; Gavin Stewart; Jayne F Tierney Journal: JAMA Date: 2015-04-28 Impact factor: 56.272
Authors: Kirsten L Johansen; Lorien S Dalrymple; Cynthia Delgado; George A Kaysen; John Kornak; Barbara Grimes; Glenn M Chertow Journal: J Am Soc Nephrol Date: 2013-10-24 Impact factor: 10.121
Authors: Stephan von Haehling; Stefan D Anker; Wolfram Doehner; John E Morley; Bruno Vellas Journal: Int J Cardiol Date: 2013-08-07 Impact factor: 4.164
Authors: Jessica Fitzpatrick; Stephen M Sozio; Bernard G Jaar; Michelle M Estrella; Dorry L Segev; Rulan S Parekh; Mara A McAdams-DeMarco Journal: Nephrol Dial Transplant Date: 2019-02-01 Impact factor: 5.992
Authors: Helen Hurst; Elizabeth Jones; Paula Ormandy; Alison Brettle; Andrew Christopher Nixon; Hannah Young; Andrew Mooney; Anna Winterbottom; Hilary Bekker; Edwina Brown; Fliss Em Murtagh; Maria Da Silva-Gane; David Coyle; Robert Finnigan Journal: BMJ Open Date: 2021-03-16 Impact factor: 2.692
Authors: Hannah M L Young; Nicki Ruddock; Mary Harrison; Samantha Goodliffe; Courtney J Lightfoot; Juliet Mayes; Andrew C Nixon; Sharlene A Greenwood; Simon Conroy; Sally J Singh; James O Burton; Alice C Smith; Helen Eborall Journal: Int J Environ Res Public Health Date: 2022-03-24 Impact factor: 3.390
Authors: Hannah M L Young; Nicki Ruddock; Mary Harrison; Samantha Goodliffe; Courtney J Lightfoot; Juliette Mayes; Andrew C Nixon; Sharlene A Greenwood; Simon Conroy; Sally J Singh; James O Burton; Alice C Smith; Helen Eborall Journal: BMC Nephrol Date: 2022-07-22 Impact factor: 2.585
Authors: Hannah M L Young; Daniel S March; Patrick J Highton; Matthew P M Graham-Brown; Darren C Churchward; Charlotte Grantham; Samantha Goodliffe; William Jones; Mei-Mei Cheung; Sharlene A Greenwood; Helen C Eborall; Simon Conroy; Sally J Singh; Alice C Smith; James O Burton Journal: BMJ Open Date: 2020-11-03 Impact factor: 2.692