Introduction:
Frailty is a geriatric syndrome characterized by sarcopenia, decreased physiological reserve against external stressors, leading to functional decline, increased risk of falls and mortality. Given the improvement in life expectancy and a large number of comorbidities in the general population, an increase in the proportion of frailty older adults on dialysis is expected.
The aim of this study is to characterize the diagnostic status of frailty in patients from the peritoneal dialysis unit at Hospital Clínico de la Universidad de Chile, and to relate it to clinical parameters (age, sex, body surface area [BSA]) and laboratory values, such as creatinine, albumin, weekly total Kt/V (wk Kt/V), weekly creatinine clearance (wCrCl), and normalized protein catabolic rate (nPCR).
Methods:
This retrospective diagnostic study included patients over 18 years old enrolled in the peritoneal dialysis program at Hospital Clínico de la Universidad de Chile in August 2024.
Frailty was assessed using the Clinical Frailty Scale (Rockwood Clinical Frailty Score, CFS), which has been validated in the peritoneal dialysis population. Patients with a CFS score of 5 or higher were considered frail. Clinical records were reviewed using electronic data, and statistical analysis was performed using univariate and bivariate methods.
Results:
A total of 39 patients were studied, 61% of whom were women, with a mean age of 56.0 ± 16.2 years. Of these, 76.3% were on automated peritoneal dialysis. Ten frail patients were identified, representing 25.6% of the cohort.
Compared to non-frail patients, frail patients were older (69.2 ± 12.9 vs. 51.5 ± 14.8 years, p=0.001), had lower plasma creatinine levels (7.2 ± 2.8 vs. 9.9 ± 3.6 mg/dL, p=0.046), lower plasma albumin levels (3.2 ± 0.5 vs. 3.7 ± 0.4 g/dL, p=0.012), and a lower BSA (1.60 ± 0.17 vs. 1.76 ± 0.19 m², p=0.025).
No significant differences were found between the groups in terms of weekly Kt/V, wCrCl, ferritin, or nPCR.
Conclusions:
In this cohort of peritoneal dialysis patients at Hospital Clínico de la Universidad de Chile, the prevalence of frailty was 25.6% based on the CFS.
Frail patients were older, had lower BSA, and lower serum levels of albumin and creatinine, suggesting that this group may be associated with malnutrition and a higher degree of sarcopenia.
Parameters such as weekly Kt/V, ferritin, wCrCl, and nPCR did not differ between the groups, indicating that these are not reliable long-term prognostic indicators in this population.
Given that frailty is associated with reduced survival, this cohort will be followed prospectively for at least two years.
I have no potential conflict of interest to disclose.
I did not use generative AI and AI-assisted technologies in the writing process.