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Prevalence of frailty in end-stage renal disease: a systematic review and meta-analysis

Kojima, G; (2017) Prevalence of frailty in end-stage renal disease: a systematic review and meta-analysis. International Urology and Nephrology , 49 (11) pp. 1989-1997. 10.1007/s11255-017-1547-5. Green open access

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Abstract

PURPOSE: The purpose of this study is to perform a systematic review and meta-analysis on prevalence of frailty among patients with end-stage renal disease (ESRD). ESRD is associated with malnutrition, chronic inflammation, acidemia, impaired hormonal changes, and low physical activity, all of which can directly and indirectly contribute to the development of frailty. Coexistence of ESRD and frailty has been shown to increase risks of adverse health outcomes. Given potential reversibility of frailty, it is important to examine frailty status in this high-risk population. METHODS: Three databases (EMBASE, Medline, and CINAHL) were systematically searched for studies providing cross-sectional data of prevalence of frailty defined by cardiovascular health study (CHS) criteria among ESRD patients. Meta-analysis calculated pooled prevalence of frailty according to modifications of CHS criteria. RESULTS: Of 837 studies identified through the systematic review, seven studies were included. Three studies used both objectively measured and self-reported CHS criteria, and two studies each used only either criteria. Pooled prevalence of frailty was 36.8% (five studies: 95% CI = 29.9-44.1%, I (2) = 82.6%, p < 0.001) and 67.0% (five studies: 95% CI = 58.7-74.7%, I (2) = 96.5%, p < 0.001) according to the objectively measured and self-reported CHS criteria, respectively. CONCLUSIONS: More than one-third of ESRD patients were frail based on the objectively measured CHS criteria, and that prevalence of frailty almost doubled with the CHS criteria substituting self-reported physical function questionnaire score for objective measurements. Given substantial difference in prevalence of frailty depending on the modifications to CHS criteria, this information should be taken into account when evaluating frailty status among ESRD population.

Type: Article
Title: Prevalence of frailty in end-stage renal disease: a systematic review and meta-analysis
Location: Netherlands
Open access status: An open access version is available from UCL Discovery
DOI: 10.1007/s11255-017-1547-5
Publisher version: http://doi.org/10.1007/s11255-017-1547-5
Language: English
Additional information: This version is the author accepted manuscript. For information on re-use, please refer to the publisher’s terms and conditions.
Keywords: Chronic kidney disease, End-stage renal disease, Frailty, Hemodialysis, Prevalence
UCL classification: UCL
URI: https://discovery-pp.ucl.ac.uk/id/eprint/1543635
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