TY - JOUR
T1 - Frailty Prevalence in Younger End-Stage Kidney Disease Patients Undergoing Dialysis and Transplantation
AU - Chu, Nadia M.
AU - Chen, Xiaomeng
AU - Norman, Silas P.
AU - Fitzpatrick, Jessica
AU - Sozio, Stephen M.
AU - Jaar, Bernard G.
AU - Frey, Alena
AU - Estrella, Michelle M.
AU - Xue, Qian Li
AU - Parekh, Rulan S.
AU - Segev, Dorry L.
AU - McAdams-Demarco, Mara A.
N1 - Funding Information:
Funding for this study was provided by the National Institute of Diabetes and Digestive and Kidney Disease and the National Institute on Aging: grant numbers K01AG064040 (PI: N.M.C.), P30AG021334 (PI: Bandeen-Roche), R01AG055781 (PI: M.A.M.-D.), R01DK114074 (PI: M.A.M.-D.), and K24DK101828 (PI: D.L.S.). Funders had no role in the study design, data collection, analysis, reporting, or decision to submit for publication.
Publisher Copyright:
© 2020
PY - 2020/7/1
Y1 - 2020/7/1
N2 - Frailty, originally characterized in community-dwelling older adults, is increasingly being studied and implemented for adult patients with end-stage kidney disease (ESKD) of all ages (18 years). Frailty prevalence and manifestation are unclear in younger adults (18-64 years) with ESKD; differences likely exist based on whether the patients are treated with hemodialysis (HD) or kidney transplantation (KT). Methods: We leveraged 3 cohorts: 378 adults initiating HD (2008-2012), 4,304 adult KT candidates (2009-2019), and 1,396 KT recipients (2008-2019). The frailty phenotype was measured within 6 months of dialysis initiation, at KT evaluation, and KT admission. Prevalence of frailty and its components was estimated by age (≥65 vs. <65 years). A Wald test for interactions was used to test whether risk factors for frailty differed by age. Results: In all 3 cohorts, frailty prevalence was higher among older than younger adults (HD: 71.4 vs. 47.3%; candidates: 25.4 vs. 18.8%; recipients: 20.8 vs. 14.3%). In all cohorts, older patients were more likely to have slowness and weakness but less likely to report exhaustion. Among candidates, older age (odds ratio [OR] = 1.79, 95% CI: 1.47-2.17), non-Hispanic black race (OR = 1.30, 95% CI: 1.08-1.57), and dialysis type (HD vs. no dialysis: OR = 2.06, 95% CI: 1.61-2.64; peritoneal dialysis vs. no dialysis: OR = 1.78, 95% CI: 1.28-2.48) were associated with frailty prevalence, but sex and Hispanic ethnicity were not. These associations did not differ by age (p
AB - Frailty, originally characterized in community-dwelling older adults, is increasingly being studied and implemented for adult patients with end-stage kidney disease (ESKD) of all ages (18 years). Frailty prevalence and manifestation are unclear in younger adults (18-64 years) with ESKD; differences likely exist based on whether the patients are treated with hemodialysis (HD) or kidney transplantation (KT). Methods: We leveraged 3 cohorts: 378 adults initiating HD (2008-2012), 4,304 adult KT candidates (2009-2019), and 1,396 KT recipients (2008-2019). The frailty phenotype was measured within 6 months of dialysis initiation, at KT evaluation, and KT admission. Prevalence of frailty and its components was estimated by age (≥65 vs. <65 years). A Wald test for interactions was used to test whether risk factors for frailty differed by age. Results: In all 3 cohorts, frailty prevalence was higher among older than younger adults (HD: 71.4 vs. 47.3%; candidates: 25.4 vs. 18.8%; recipients: 20.8 vs. 14.3%). In all cohorts, older patients were more likely to have slowness and weakness but less likely to report exhaustion. Among candidates, older age (odds ratio [OR] = 1.79, 95% CI: 1.47-2.17), non-Hispanic black race (OR = 1.30, 95% CI: 1.08-1.57), and dialysis type (HD vs. no dialysis: OR = 2.06, 95% CI: 1.61-2.64; peritoneal dialysis vs. no dialysis: OR = 1.78, 95% CI: 1.28-2.48) were associated with frailty prevalence, but sex and Hispanic ethnicity were not. These associations did not differ by age (p
UR - http://www.scopus.com/inward/record.url?scp=85087874851&partnerID=8YFLogxK
UR - http://www.scopus.com/inward/citedby.url?scp=85087874851&partnerID=8YFLogxK
U2 - 10.1159/000508576
DO - 10.1159/000508576
M3 - Article
C2 - 32640462
AN - SCOPUS:85087874851
SN - 0250-8095
VL - 51
SP - 501
EP - 510
JO - American Journal of Nephrology
JF - American Journal of Nephrology
IS - 7
ER -