Frail phenotype might herald bone health worsening among end-stage renal disease patients
Journal
PeerJ
Journal Volume
2017
Journal Issue
7
Pages
e3542
Date Issued
2017
Author(s)
Cohort of Geriatric Nephrology in NTUH (COGENT) study group
Abstract
Background. Frailty exhibits a high prevalence in end-stage renal disease (ESRD)patients and is associated with adverse health-related outcomes, including falls andfractures. Available studies do not address whether frailty is associated with temporalchanges in BMD. We evaluated this issue by analyzing the follow-up dual energy X-rayabsorptiometry (DXA) results in an ESRD cohort.Methods. In 2015, we enrolled forty-three ESRD patients, divided into frail, pre-frail,and robust ones based on a validated simple FRAIL scale, all receiving DXA at baseline.After one year of follow-up, survivors received another DXA, and we calculated theabsolute and percentage changes in area, bone mineral density (BMD), T-, and Z-scoresof lumbar spine and femoral neck (FN) between baseline and follow-up examinations.Results. Among all, frail individuals with ESRD had significantly lower average lumbarspine area, lower L4, FN, and totalBMDand T-scores, lower FN and total Z-scores thannon-frail ones, without differences in gender, body mass index, dialysis duration, andcomorbidities. Furthermore, we discovered frail ESRD patients had significantly moreprominent decrease in average lumbar spine area, percentage changes in L1 Z-scoresand average lumbar spine area, and a trend toward more prominent decrease in L4 areathan non-frail ones after one year of follow-up.Conclusions. Baseline frailty might be associated with deteriorating bone health,including shrinking L-spine areas and a more rapid decrease in L-spine Z scores, amongESRD patients. This frailty-bone association should be highlighted during our care offrail individuals with ESRD.
SDGs
Publisher
PeerJ Inc.
Type
journal article