The impact of frailty and malnutrition on hospitalisation and survival in people with kidney failure.

IF 2.6 4区 医学 Q2 UROLOGY & NEPHROLOGY
Dawson Jessica, Smyth Brendan, Ryan Michele, Randall Ann-Maree, Clifford Katharine, Thomsett Max, Li Chen-Lei Kelly, Mark A Brown
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Abstract

Background: Malnutrition and frailty are common, with rates increasing as kidney disease progresses and with ageing. Conservative kidney management has emerged as a kidney failure treatment that prioritises quality of life and symptom management, typically offered to the elderly. The aim of this study was to determine the incidence and impact of frailty and malnutrition on hospitalisations, quality of life and mortality in people with kidney failure.

Methods: This two-year longitudinal study recruited people choosing conservative kidney management and, as a comparator group, people aged 75 years and over who were commenced on dialysis. Participants underwent assessment of frailty, nutritional status and quality of life every 6 months. Hospitalisation and death data were extracted from medical records.

Results: A total of 85 participants were recruited (n = 60 conservative kidney management, n = 25 dialysis). At baseline, 56% were assessed as frail and 33% as malnourished. In the total cohort, frailty was associated with a higher rate of hospitalisations, and longer hospital stays. These associations appeared to be driven by the dialysis group, as no differences in hospitalisation rates or length of stay were observed in the conservative kidney management group based on frailty status. In the conservative kidney management group, frailty was not associated with mortality (HR 1.42, 95% CI 0.71-2.84; p = 0.3), however, being malnourished was associated with reduced 2-year survival (HR 2.10, 95% CI 1.13-3.90; p = 0.024).

Conclusions: Frailty and malnutrition are common, resulting in adverse outcomes in elderly conservative kidney management and dialysis populations. Nutrition is a key intervention in both frailty and malnutrition, with clinical trials needed to evaluate safe and effective interventions.

虚弱和营养不良对肾衰竭患者住院和生存的影响。
背景:营养不良和虚弱是常见的,随着肾脏疾病的进展和年龄的增长,发病率增加。保守肾管理已成为一种肾衰竭治疗,优先考虑生活质量和症状管理,通常提供给老年人。本研究的目的是确定衰弱和营养不良对肾衰竭患者住院治疗、生活质量和死亡率的发生率和影响。方法:这项为期两年的纵向研究招募了选择保守肾管理的人,作为比较组,75岁及以上开始透析的人。每6个月对参与者的虚弱程度、营养状况和生活质量进行评估。住院和死亡数据从医疗记录中提取。结果:共招募了85名参与者(n = 60保守肾管理,n = 25透析)。在基线时,56%被评估为虚弱,33%被评估为营养不良。在整个队列中,虚弱与较高的住院率和较长的住院时间有关。这些关联似乎是由透析组驱动的,因为在基于虚弱状态的保守肾管理组中,没有观察到住院率或住院时间的差异。在保守肾管理组,虚弱与死亡率无关(HR 1.42, 95% CI 0.71-2.84;p = 0.3),然而,营养不良与2年生存率降低相关(HR 2.10, 95% CI 1.13-3.90;p = 0.024)。结论:虚弱和营养不良是老年人保守肾管理和透析人群中常见的不良后果。营养是治疗虚弱和营养不良的关键干预措施,需要进行临床试验来评估安全有效的干预措施。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
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来源期刊
Journal of Nephrology
Journal of Nephrology 医学-泌尿学与肾脏学
CiteScore
5.60
自引率
5.90%
发文量
289
审稿时长
3-8 weeks
期刊介绍: Journal of Nephrology is a bimonthly journal that considers publication of peer reviewed original manuscripts dealing with both clinical and laboratory investigations of relevance to the broad fields of Nephrology, Dialysis and Transplantation. It is the Official Journal of the Italian Society of Nephrology (SIN).
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