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Aging and Disease    2018, Vol. 9 Issue (2) : 192-207     DOI: 10.14336/AD.2017.0429
Orginal Article |
The Prevalence of Frailty and its Associated Factors in Japanese Hemodialysis Patients
Hidemi Takeuchi1,7,Haruhito A. Uchida1,2,*,Yuki Kakio1,Yuka Okuyama1,Michihiro Okuyama3,Ryoko Umebayashi1,Kentaro Wada4,Hitoshi Sugiyama1,5,Ken Sugimoto6,Hiromi Rakugi6,Jun Wada1
1Department of Nephrology, Rheumatology, Endocrinology and Metabolism, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, Okayama, Japan.
2Department of Chronic Kidney Disease and Cardiovascular Disease, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, Okayama, Japan.
3Department of Cardiovascular Surgery, Okayama University Hospital, Okayama, Japan.
4Division of Nephrology and Dialysis, Department of Internal Medicine, Nippon Kokan Fukuyama Hospital, Hiroshima, Japan.
5Department of Human Resource Development of Dialysis Therapy for Kidney Disease, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, Okayama, Japan.
6Department of Geriatric and General Medicine, Osaka University Graduate School of Medicine, Osaka, Japan.
7Department of Internal Medicine, Innoshima General Hospital, Hiroshima, Japan
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The population undergoing dialysis is aging worldwide, particularly in Japan. The clinical condition of frailty is the most problematic expression in the elderly population. Potential pathophysiological factors of frailty present in patients with CKD and are accentuated in patients with ESRD. The aim of this study was to identify the prevalence and predictors of frailty in Japanese HD patients. This study was a multicenter, cross-sectional and observational investigation conducted at 6 institutions. To evaluate frailty, the modified Fried’s frailty phenotype adjusted for Japanese as the self-reported questionnaire was used. Of the 542 patients visiting each institution, 388 were enrolled in this study. In total, 26.0% of participants were categorized as not-frailty, 52.6% as pre-frailty and 21.4% as frailty. The prevalence of frailty increased steadily with age and was more prevalent in females than in males and the subjects with frailty received polypharmacy. A multivariate logistic regression analysis revealed that the factors independently associated with frailty were the following: female gender (odds ratio [OR] = 3.661, 95% confidence interval [CI] 1.398-9.588), age (OR = 1.065, 95% CI 1.014-1.119), age ≥ 75 years old (OR = 4.892, 95% CI 1.715-13.955), body mass index (BMI) < 18.5 (OR = 0.110, 95% CI 0.0293-0.416), number of medications being taken (OR = 1.351, 95% CI 1.163-1.570), diabetes mellitus (DM) (OR = 2.765, 95% CI 1.081-7.071) and MNA-SF ≤ 11 (OR = 7.405, 95% CI 2.732-20.072). Frailty was associated with the accumulation of risk factors. The prevalence of frailty in Japanese patients with HD was relatively lower than that previously reported in Western developed countries; however, it was extremely high compared to the general population regardless of age. Our findings suggest that frailty might be associated with an increase in the prevalence of adverse health outcomes in patients with HD.

Keywords Frailty      Dialysis      Frailty phenotype     
Corresponding Authors: Haruhito A. Uchida   
Issue Date: 01 April 2018
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Hidemi Takeuchi
Haruhito A. Uchida
Yuki Kakio
Yuka Okuyama
Michihiro Okuyama
Ryoko Umebayashi
Kentaro Wada
Hitoshi Sugiyama
Ken Sugimoto
Hiromi Rakugi
Jun Wada
Cite this article:   
Hidemi Takeuchi,Haruhito A. Uchida,Yuki Kakio, et al. The Prevalence of Frailty and its Associated Factors in Japanese Hemodialysis Patients[J]. A&D, 2018, 9(2): 192-207.
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