Applicability of laboratory deficit-based frailty index in predominantly older patients with end-stage renal disease under chronic dialysis: A pilot test of its correlation with survival and self-reported instruments
Journal
Nephrology
Journal Volume
25
Journal Issue
1
Pages
73-81
Date Issued
2020
Author(s)
COhort of GEriatric Nephrology in NTUH (COGENT) Study Group
Abstract
Aim: Laboratory deficit-based frailty index (LFI) exhibited outcome-prediction ability in the elderly, but not in those with end-stage renal disease (ESRD). We hypothesized that LFI results might have outcome correlation and correlate closely with other instruments in ESRD patients. Methods: We prospectively enroled ESRD patients between 2014 and 2015 and administered self-report frailty instruments (Strawbridge questionnaire, Edmonton frail scale (EFS), Groningen frailty indicator (GFI), Tilburg frailty indicator, G8 questionnaire and FRAIL scale), and Cardiovascular Health Study (CHS) scale, with two types of LFI calculated. They were followed up until June 30, 2017. Correlations between the results of six instruments, CHS scale, and those of LFI were identified, followed by Kaplan–Meier survival analyses and logistic regression analyses to compare those with high and low LFI. Results: The frailty prevalence was 33.3% (CHS), 78.8% Strawbridge questionnaire, 45.5% (EFS), 57.6% (GFI), 27.3% (Tilburg frailty indicator), 84.8% (G8) and 18.2% (FRAIL) among ESRD participants. LFI-1 results were significantly correlated with those of LFI-2 (P < 0.01), EFS (P = 0.04) and GFI (P < 0.01), while LFI-2 results were not. Those with CHS or GFI-identified frailty had significantly lower 1,25-(OH)2-D levels than those without. After 32.3 ± 5.4 months, patients with high LFI-1 scores, but not LFI-2, had a significantly higher mortality than those with lower scores. GFI and EFS scores were also independently associated with LFI-1, while CHS scores exhibited borderline association only. Conclusion: Among a group of predominantly older ESRD patients, LFI differentiates patients with good and poor outcomes, supporting its applicability in these patients. ? 2019 Asian Pacific Society of Nephrology
SDGs
Other Subjects
aged; Article; Cardiovascular Health Study; clinical article; clinical outcome; cohort analysis; controlled study; correlational study; Edmonton Frail Scale; end stage renal disease; female; FRAIL scale; functional status assessment; G8 questionnaire; Groningen frailty indicator; human; human cell; laboratory deficit based frailty index; male; mortality; pilot study; prevalence; priority journal; prospective study; renal replacement therapy; Strawbridge questionnaire; survival analysis; Tilburg frailty indicator; adverse event; age; blood; blood pressure; chronic kidney failure; comparative study; epidemiology; frailty; geriatric assessment; heart rate; hemodialysis; middle aged; pathophysiology; predictive value; risk assessment; risk factor; self report; Taiwan; treatment outcome; biological marker; Age Factors; Aged; Biomarkers; Blood Pressure; Female; Frailty; Geriatric Assessment; Heart Rate; Humans; Kidney Failure, Chronic; Male; Middle Aged; Pilot Projects; Predictive Value of Tests; Prevalence; Prospective Studies; Renal Dialysis; Risk Assessment; Risk Factors; Self Report; Taiwan; Treatment Outcome
Publisher
Blackwell Publishing
Type
journal article