Zhongguo quanke yixue (Jul 2024)

Prevalence and Influencing Factors of Frailty in Maintenance Hemodialysis Patients in China: a Meta-analysis

  • WANG Xiaoxia, CAO Xuehua, LI Yan, XIONG Langyu, HU Wanqin, XIANG Feng, JIA Yu

DOI
https://doi.org/10.12114/j.issn.1007-9572.2023.0687
Journal volume & issue
Vol. 27, no. 20
pp. 2534 – 2544

Abstract

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Background Chronic kidney disease has become a major global concern, and the prevalence of kidney disease in China is the highest in the world. About 89.5% of patients require hemodialysis. In recent years, the prevalence of frailty in maintenance hemodialysis (MHD) patients has risen significantly, seriously affecting the quality of life and prognosis of patients. Objective To explore the prevalence of frailty and the influencing factors of maintenance hemodialysis patients in China through Meta-analysis. Methods Cross-sectional and cohort studies on the prevalence and influencing factors of frailty in Chinese MHD patients were systematically searched in CNKI, VIP, CBM, Wanfang Data, Web of Science, PubMed, Cochrane Library, Embase, and CINAHL databases. The search deadline was from the respective databases to July 2023. Literature screening, data extraction and quality assessment were performed independently by two researchers. Stata 15.0 was used for meta-analysis. Results Thirty-two papers were included, and including 6 746 patients, among which 2 566 experienced frailty, involving 37 influencing factors. Meta-analysis showed that the prevalence of frailty in MHD patients in China was 37.4% (95%CI=30.3%-44.5%). Age (OR=1.09, 95%CI=1.06-1.13), age>60 years (OR=3.81, 95%CI=2.31-6.30), female (OR=2.13, 95%CI=1.47-3.08), living alone (OR=2.42, 95%CI=1.22-4.80), sleep (OR=1.28, 95%CI=1.08-1.50), depression (OR=1.97, 95%CI=1.26-3.08), age on dialysis (OR=3.25, 95%CI=1.82-5.79), social support (low level) (OR=1.99, 95%CI=1.39-2.86), comorbidities (OR=1.79, 95%CI=1.40-2.30), malnutrition (OR=1.17, 95%CI=1.07-1.28), Charlson Comorbidity Index (CCI) (OR=1.32, 95%CI=1.01-1.71), C-reactive protein (CRP) (OR=1.15, 95%CI=1.09-1.21), hemoglobin (Hb<110 g/L) (OR=2.70, 95%CI=1.67-4.36), comorbid diabetes (OR=2.16, 95%CI=1.48-3.16), comorbid cerebrovascular disease (OR=2.66, 95%CI=1.85-3.82), comorbid coronary heart disease (OR=3.50, 95%CI=2.15-5.70) were risk factors for frailty MHD (P<0.05) ; economic income (OR=0.02, 95%CI=0.01-0.14), social support (high level) (OR=0.86, 95%CI=0.76-0.97), well nutrition (OR=0.47, 95%CI=0.26-0.85), ability to perform activities of daily living (ADL) (OR=0.80, 95%CI=0.70-0.91), serum albumin (ALB) (OR=0.84, 95%CI=0.77-0.91), Hb≥110 g/L (OR=0.70, 95%CI=0.54-0.90), 25-hydroxyvitamin D[25- (OH) VD] (OR=0.69, 95%CI=0.49-0.98) were protective factors for MHD frailty (P<0.05) . Conclusion The prevalence of frailty in MHD patients in China is at a high level, in which age, female, living alone, economic income, sleep, depression, age on dialysis, social support, comorbidities, nutritional risk scores, ADL, CCI, CRP, ALB, Hb, 25- (OH) VD, comorbid diabetes mellitus, comorbid cerebrovascular disease, and comorbid coronary heart disease are mainly factors influencing of MHD frailty patients in China, and in the future, there is a need for early screening and intervention to slow down or avoid the occurrence of hemodialysis frailty in patients.

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