Optimizing dialysis dose in the context of frailty: an exploratory study
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Fecha
2020
Autores
Hernandez‑Agudelo, Sandra Y.
Musso, Carlos G.
González‑Torres, Henry J.
Castro‑Hernández, Christian
Maya‑Altamiranda, Lina P.
Quintero‑Cruz, María V.
Corradino, Claudio
Terrasa, Sergio A.
Aroca‑Martínez, Gustavo J.
Cadena‑Bonfanti, Andrés
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Editor
Springer Nature
Resumen
Introduction Frailty is a multicausal syndrome characterized by a decrease in strength, resistance and physiological function,
which makes the individual vulnerable and dependent, and increases his/her mortality. This syndrome is more prevalent
among older individuals, and chronic kidney disease patients, particularly those on dialysis. Dialysis dose is currently
standardized for hemodialysis (HD) patients regardless of their age and functional status. However, it has been postulated
that the dialysis dose required in older patients, especially frail ones, should be lower, since it could increase their degree
of frailty. Then, the purpose of this study was to evaluate if there would be a correlation between the dose of Kt/V and the
degree of frailty in a population of adult patients on HD.
Materials and methods A cross-sectional study with 82 patients on HD in Barranquilla (Colombia) and Lobos (Argentina)
was conducted. Socio-demographic and laboratory data, as well as dialysis doses (Kt/V) were recorded and scales of fragility,
physical activity, gait and grip strength were applied. Then these data were correlated by a Spearman’s correlation and
a logistic regression.
Results CFS, social isolation, physical activity, gait speed, and prehensile strength tests were outside the reference ranges
in the studied group. No significant correlation was found between dialysis dose and all the above mentioned functional
tests. However, a significant and inverse correlation between physical activity and CFS was documented (score − 1.41 (CI
− 2.1 to − 0.7).
Conclusion No significant correlation was documented between Kt/V value and different parameters of the frailty status, but
this status correlated significantly and inversely with physical activity in this group. Frailty status in hemodialysis patients
was significantly higher in older individuals, although young individuals were not exempt from it.
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Palabras clave
Frailty, Dialysis dose, Hemodialysis
