Study of clinical assessment of frailty in patients on maintenance hemodialysis supported by cashless government scheme

• Published in: Saudi journal of kidney diseases and transplantation Vol. 28; no. 1; pp. 15 - 22
• Main Authors: Yadla, Manjusha, Mummadi, Mahesh, John, Jyothi Priyadarshini
• Format: Journal Article
• Language: English
• Published: Riyadh, Saudi Arabia Saudi Center for Organ Transplantation 2017; Wolters Kluwer India Pvt. Ltd; Medknow Publications and Media Pvt. Ltd; Medknow Publications & Media Pvt. Ltd; Wolters Kluwer Medknow Publications
• Subjects: Accidental Falls - mortality; Adult; Comorbidity; Epidemiology; Female; Frailty - diagnosis; Frailty - mortality; Frailty - therapy; Health aspects; Health Status; Hemodialysis; Humans; India - epidemiology; Kidney Diseases - diagnosis; Kidney Diseases - mortality; Kidney Diseases - therapy; Male; Medical Assistance; Middle Aged; Patient Admission; Prevalence; Prospective Studies; Renal Dialysis - adverse effects; Renal Dialysis - mortality; Risk Assessment; Risk Factors; Smoking - adverse effects; Smoking - mortality; Time Factors; Treatment Outcome; الأمراض; التقييم; الكلى; المرضى; غسيل الكلى; هشاشة العظام; India; Saudi Arabia
• ISSN: 1319-2442; 2320-3838
• DOI: 10.4103/1319-2442.198102

This is a prospective cohort study to assess the prevalence of frailty in patients
undergoing maintenance hemodialysis (HD) under the government-funded scheme at our center and
to assess the relationship between frailty and falls, hospitalizations, and mortality. This was done at
our center which is completely supported by the government, which provides HD to all the patients
under poverty line. Epidemiological data, anthropometric measurements, comorbidities assessment,
frailty assessment using Fried criteria, subsequent hospitalizations, falls, and mortality were
recorded in our prevalent dialysis population at our center between October 2014 and October 2015.
Two hundred and twenty-six patients were enrolled during this period. Twenty-one patients were
excluded as they did not satisfy the inclusion criteria. Two hundred and five prospective patients
were studied for the predictors of frailty. Frailty was present in 82% of the study population. Mean
age of our study population was 44.95 ± 13.27 years. On univariate analysis, diabetes mellitus,
hypertension (HTN), cerebrovascular accident (CVA), left ventricular dysfunction (LVD), peripheral
vascular disease (PVD), smoking, hepatitis C, inadequate dialysis, intradialytic hypotension
(IDH), interdialytic weight gain, low serum creatinine <4 mg/dL, and anemia (Hb <10 g/dL) were
found to be statistically significantly different between frail and nonfrail groups On multivariate
regression analysis, only HTN, PVD, CVA, anemia, smoking, and IDH were found to be significant.
Frailty is highly prevalent among dialysis population. Factors predicting frailty include HTN,
smoking, LVD, PVD, CVA, smoking, anemia, and IDH. Frailty is a significant risk factor for falls
and hospitalizations.