Association Between Residual Kidney Function and Frailty in End-Stage Renal Disease Patients Undergoing Hemodialysis: A Cross-Sectional Study.

IF 2.5 Q2 UROLOGY & NEPHROLOGY

International Journal of Nephrology and Renovascular Disease Pub Date : 2025-08-21 eCollection Date: 2025-01-01 DOI:10.2147/IJNRD.S532499

Piboon Showtanapanich, Chadawan Pathonsmith, Jiraporn Sri-On, Appasornsawan Jatutain, Tanun Ngamvichchukorn

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Abstract

Background: Residual kidney function (RKF) plays a crucial role in maintaining biochemical balance in hemodialysis patients. Frailty, commonly observed in end-stage renal disease (ESRD) patients, is associated with metabolic derangements, inflammation, and fluid overload. However, the relationship between RKF and frailty in this population remains unclear.

Purpose: This study aimed to investigate the association between RKF and frailty in ESRD patients undergoing hemodialysis. Secondary objectives included assessing the prevalence of frailty and sarcopenia, and identifying clinical correlates.

Patients and methods: A cross-sectional study was conducted involving 110 adult ESRD patients undergoing maintenance hemodialysis for ≥6 months at an urban teaching hospital in Bangkok, Thailand between October 2023 and February 2024. RKF was assessed by 24-hour urine volume, with <100 mL defined as absent RKF. Frailty was evaluated using the Thai version of the FRAIL scale, and sarcopenia was diagnosed based on the 2019 Asian Working Group for Sarcopenia (AWGS) criteria. Demographic, clinical, and laboratory data were analyzed using chi-squared tests, logistic regression, and multivariable models.

Results: Among 110 participants, 78 (70.91%) had no RKF. Frailty prevalence was 13.64%, and sarcopenia prevalence was 65.45%. Frailty was associated with a history of cerebrovascular accident [adjusted odds ratio (OR) 10.303; P = 0.036] and lower total iron-binding capacity (TIBC) (adjusted OR 0.972; P = 0.047). Sarcopenia was linked to advanced age (adjusted OR 1.054; P = 0.020) and lower Kt/V values (adjusted OR 0.417; P = 0.002). RKF was not significantly associated with frailty.

Conclusion: While RKF was not directly associated with frailty, this study highlights other significant factors, such as cerebrovascular accidents and low TIBC, contributing to frailty and advanced age associated with sarcopenia. These findings emphasize the need for comprehensive frailty screening and tailored interventions to improve outcomes in ESRD patients.

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终末期肾脏疾病血液透析患者残留肾功能与虚弱之间的关系：一项横断面研究

背景：残余肾功能（RKF）在维持血液透析患者的生化平衡中起着至关重要的作用。虚弱常见于终末期肾病（ESRD）患者，与代谢紊乱、炎症和体液超载有关。然而，在这一人群中，RKF与脆弱之间的关系尚不清楚。目的：本研究旨在探讨血液透析的ESRD患者RKF与衰弱的关系。次要目标包括评估虚弱和肌肉减少症的患病率，并确定临床相关性。患者和方法：一项横断面研究于2023年10月至2024年2月在泰国曼谷的一家城市教学医院进行了110例≥6个月维持性血液透析的成年ESRD患者。通过24小时尿量评估RKF，结果：110名参与者中，78名（70.91%）无RKF。虚弱患病率为13.64%，肌肉减少症患病率为65.45%。虚弱与脑血管意外史相关[校正优势比（OR） 10.303；P = 0.036]和总铁结合力（TIBC）较低（调整OR 0.972; P = 0.047）。骨骼肌减少症与高龄（调整OR 1.054; P = 0.020）和较低的Kt/V值（调整OR 0.417; P = 0.002）有关。RKF与虚弱无显著相关。结论：虽然RKF与虚弱没有直接关系，但本研究强调了其他重要因素，如脑血管意外和低TIBC，有助于虚弱和与肌肉减少症相关的高龄。这些发现强调需要全面的衰弱筛查和量身定制的干预措施来改善ESRD患者的预后。

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

International Journal of Nephrology and Renovascular Disease UROLOGY & NEPHROLOGY-

CiteScore

3.90

自引率

5.00%

发文量

审稿时长

16 weeks

期刊介绍： International Journal of Nephrology and Renovascular Disease is an international, peer-reviewed, open-access journal focusing on the pathophysiology of the kidney and vascular supply. Epidemiology, screening, diagnosis, and treatment interventions are covered as well as basic science, biochemical and immunological studies. In particular, emphasis will be given to: -Chronic kidney disease- Complications of renovascular disease- Imaging techniques- Renal hypertension- Renal cancer- Treatment including pharmacological and transplantation- Dialysis and treatment of complications of dialysis and renal disease- Quality of Life- Patient satisfaction and preference- Health economic evaluations. The journal welcomes submitted papers covering original research, basic science, clinical studies, reviews & evaluations, guidelines, expert opinion and commentary, case reports and extended reports. The main focus of the journal will be to publish research and clinical results in humans but preclinical, animal and in vitro studies will be published where they shed light on disease processes and potential new therapies and interventions.