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Optimizing dialysis dose in the context of frailty: an exploratory study
Sandra Y Hernandez-Agudelo1, Carlos G Musso2,3,4, Henry J González-Torres5,6
1Departamento de Nefrología, Clínica de la Costa, Barranquilla, Colombia.
International Urology and Nephrology
|January 30, 2021
Summary
This study found no link between dialysis dose (Kt/V) and frailty in hemodialysis patients. However, physical activity was inversely correlated with frailty, suggesting its importance for this vulnerable population.
Area of Science:
- Nephrology
- Geriatrics
- Internal Medicine
Background:
- Frailty is a common syndrome in older adults and chronic kidney disease (CKD) patients, particularly those on hemodialysis (HD).
- Current HD protocols use a standardized dialysis dose (Kt/V) irrespective of patient age or functional status.
- There is a hypothesis that a lower dialysis dose may be beneficial for frail, older HD patients to prevent increased frailty.
Purpose of the Study:
- To investigate the correlation between dialysis dose (Kt/V) and the degree of frailty in adult patients undergoing hemodialysis.
- To assess the relationship between dialysis dose and various frailty indicators, including physical activity, gait speed, and grip strength.
Main Methods:
- A cross-sectional study involving 82 hemodialysis patients from Colombia and Argentina.
- Data collected included socio-demographic information, laboratory results, dialysis dose (Kt/V), and frailty assessments (e.g., Clinical Frailty Scale, physical activity, gait speed, grip strength).
- Statistical analyses included Spearman's correlation and logistic regression to evaluate relationships between variables.
Main Results:
- Most patients exhibited abnormal results in frailty assessments, including the Clinical Frailty Scale (CFS), social isolation, physical activity, gait speed, and grip strength.
- No significant correlation was found between the dialysis dose (Kt/V) and any of the measured frailty parameters.
- A significant inverse correlation was observed between physical activity levels and the Clinical Frailty Scale (CFS) score (r = -1.41).
Conclusions:
- The dialysis dose (Kt/V) does not appear to correlate with the degree of frailty in this hemodialysis patient cohort.
- Physical activity demonstrated a significant inverse correlation with frailty, highlighting its potential role in mitigating frailty in HD patients.
- While frailty was more prevalent in older individuals, younger patients on hemodialysis were also susceptible to developing frailty.
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