スギモト ケン   Ken Sugimoto
  杉本 研
   所属   川崎医科大学  医学部 臨床医学 総合老年医学
   職種   教授
論文種別 原著
言語種別 英語
査読の有無 査読あり
表題 The Prevalence of Frailty and its Associated Factors in Japanese Hemodialysis Patients.
掲載誌名 正式名:Aging and disease
略  称:Aging Dis
ISSNコード:21525250/21525250
掲載区分国外
巻・号・頁 9(2),pp.192-207
著者・共著者 Takeuchi Hidemi, Uchida Haruhito A, Kakio Yuki, Okuyama Yuka, Okuyama Michihiro, Umebayashi Ryoko, Wada Kentaro, Sugiyama Hitoshi, Sugimoto Ken, Rakugi Hiromi, Wada Jun
発行年月 2018/04
概要 The population undergoing dialysis is aging worldwide, particularly in Japan. The clinical condition of frailty is the most problematic expression in the elderly population. Potential pathophysiological factors of frailty present in patients with CKD and are accentuated in patients with ESRD. The aim of this study was to identify the prevalence and predictors of frailty in Japanese HD patients. This study was a multicenter, cross-sectional and observational investigation conducted at 6 institutions. To evaluate frailty, the modified Fried's frailty phenotype adjusted for Japanese as the self-reported questionnaire was used. Of the 542 patients visiting each institution, 388 were enrolled in this study. In total, 26.0% of participants were categorized as not-frailty, 52.6% as pre-frailty and 21.4% as frailty. The prevalence of frailty increased steadily with age and was more prevalent in females than in males and the subjects with frailty received polypharmacy. A multivariate logistic regression analysis revealed that the factors independently associated with frailty were the following: female gender (odds ratio [OR] = 3.661, 95% confidence interval [CI] 1.398-9.588), age (OR = 1.065, 95% CI 1.014-1.119), age ≥ 75 years old (OR = 4.892, 95% CI 1.715-13.955), body mass index (BMI) < 18.5 (OR = 0.110, 95% CI 0.0293-0.416), number of medications being taken (OR = 1.351, 95% CI 1.163-1.570), diabetes mellitus (DM) (OR = 2.765, 95% CI 1.081-7.071) and MNA-SF ≤ 11 (OR = 7.405, 95% CI 2.732-20.072). Frailty was associated with the accumulation of risk factors. The prevalence of frailty in Japanese patients with HD was relatively lower than that previously reported in Western developed countries; however, it was extremely high compared to the general population regardless of age. Our findings suggest that frailty might be associated with an increase in the prevalence of adverse health outcomes in patients with HD.
DOI 10.14336/AD.2017.0429
PMID 29896410