Analysis Of Frailty Status And Influencing Factors In Elderly Patients With Chronic Kidney Disease

Backgrands and Objective:Frailty is a multi-dimensional syndrome of old age.It is the result of the progressive and persistent deterioration of many physiological processes.It has a high incidence in the elderly and can lead to a severely poor prognosis.In view of the continued increase in the prevalence of chronic kidney disease(CKD)in the elderly,this study aims to investigate the epidemiological distribution of frailty in elderly CKD patients and explore its influencing factors,in order to provide evidence for interventions in frail elderly CKD patients.METHODS:A cross-sectional study was conducted on patients who were hospitalized in the Nephrology Department of the Second Affiliated Hospital of Nanchang University from 2020.08.01 to 2020.11.30,diagnosed with CKD and did not enter dialysis,and collected general sociological statistics of the included patients through questionnaires,The number of unplanned hospitalizations in the past year,sleep quality,primary disease,comorbidities and other information,and the use of radionuclide renal dynamic imaging to determine the glomerular filtration rate(m GFR),determination of serum iron and ferritin and other iron metabolism indexes by ferrazine method and immunoturbidimetric method,collect 25-hydroxyvitamin D[25(0H)D],hemoglobin(Hb)and other indicators,evaluate the frailty of the included patients through the frailty scale(FS),and divide the included patients into no frailty or frailty according to the FS score The three groups of pre-dialysis and frailty were used to analyze the differences between the indicators of each group using chi-square test,rank-sum test,and one-way variance.Multi-class Logistics regression was used to analyze the influencing factors of frailty in elderly patients with CKD before dialysis.Results:(1)(1)A total of 167 non-dialysis inpatients diagnosed with elderly CKD were included in this study,including 106 males(63.4%)and 61 females(36.6%),aged60-89 years old,with an average of(69.97 ± 6.77)years old.(2)Among the included patients,33 cases(19.8%)were not debilitated,78 cases(46.7%)were pre-debilitated,and 56 cases(33.5%)were debilitated.(2)No frailty,pre-frailty,and frailty in the three groups: m GFR,CKD staging,serum iron(SI),transferrin saturation(TS),sleep quality,age,unplanned hospitalization,multiple medications,cultural level,combined mental effort The differences in failure,25(0H)D,Hb,albumin(Alb),corrected calcium(Ca),hematocrit(HCT),red blood cell(RBC),and B-type brain natriuretic peptide(BNP)are statistically significant(All P<0.001).(3)The differences in body mass index(BMI),living alone,combined with ischemic heart disease,and uric acid levels in the three groups without frailty,pre-frailty,and frailty were statistically significant(all P<0.05).(4)Multi-class logistic regression analysis.For elderly CKD patients without frailty,unplanned hospitalization and multi-drug use were independent risk factors for pre-frailty and frailty(all P<0.05).(5)Multi-category Logistics regression analysis.For patients with pre-debility,age(OR: 1.092,P=0.036),unplanned hospitalization(OR: 7.684,P <0.001),combined with heart failure(OR: 6.641,P=0.005))Is an independent risk factor for frailty.Good sleep quality(OR: 0.118,P=0.002)and high hematocrit(OR: 0.822,P<0.001)are independent protective factors.Conclusions:The incidence of frailty in hospitalized elderly patients with CKD before dialysis is high.Elderly CKD patients should be routinely assessed for frailty.Early recognition of frailty in elderly CKD patients is of great significance for improving the quality of life of patients.The occurrence of frailty in elderly patients with CKD is affected by many factors such as unplanned hospitalization,multiple medications,age,sleep quality,hematocrit,iron metabolism indicators,renal function and other factors.Actively improving sleep quality and anemia symptoms may help reduce elderly CKD patients Incidence of debilitating.