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Frailty phenotype and chronic kidney disease: a review of the literature.
Int Urol Nephrol. 2015 Nov; 47(11):1801-7.IU

Abstract

Frailty is a construct originally coined by gerontologists to describe cumulative declines across multiple physiological systems that occur with aging and lead individuals to a state of diminished physiological reserve and increased vulnerability to stressors. Fried et al. provided a standardized definition for frailty, and they created the concept of frailty phenotype which incorporates disturbances across interrelated domains (shrinking, weakness, poor endurance and energy, slowness, and low physical activity level) to indentify old people who are at risk of disability, falls, institutionalization, hospitalization, and premature death. Some authors consider the presence of lean mass reduction (sarcopenia) as part of the frailty phenotype. The frailty status has been documented in 7 % of elderly population and 14 % of not requiring dialysis CKD adult patients. Sarcopenia increases progressively along with loss of renal function in CKD patients and is high in dialysis population. It has been documented that prevalence of frailty in hemodialysis adult patients is around 42 % (35 % in young and 50 % in elderly), having a 2.60-fold higher risk of mortality and 1.43-fold higher number of hospitalization, independent of age, comorbidity, and disability. The Clinical Frailty Scale is the simplest and clinically useful and validated tool for doing a frailty phenotype, while the diagnosis of sarcopenia is based on muscle mass assessment by body imaging techniques, bioimpedance analysis, and muscle strength evaluated with a handheld dynamometer. Frailty treatment can be based on different strategies, such as exercise, nutritional interventions, drugs, vitamins, and antioxidant agents. Finally, palliative care is a very important alternative for very frail and sick patients. In conclusion, since the diagnosis and treatment of frailty and sarcopenia is crucial in geriatrics and all CKD patients, it would be very important to incorporate these evaluations in pre-dialysis, peritoneal dialysis, hemodialysis, and kidney transplant patients in order to detect and consequently treat the frailty phenotype in these groups.

Authors+Show Affiliations

Ageing Biology Unit, Hospital Italiano de Buenos Aires, Buenos Aires, Argentina. carlos.musso@hospitalitaliano.org.ar.Ageing Biology Unit, Hospital Italiano de Buenos Aires, Buenos Aires, Argentina.Nephrology Division, Hospital Universitario de Salamanca, Salamanca, Spain.

Pub Type(s)

Journal Article
Review

Language

eng

PubMed ID

26411428

Citation

Musso, Carlos G., et al. "Frailty Phenotype and Chronic Kidney Disease: a Review of the Literature." International Urology and Nephrology, vol. 47, no. 11, 2015, pp. 1801-7.
Musso CG, Jauregui JR, Macías Núñez JF. Frailty phenotype and chronic kidney disease: a review of the literature. Int Urol Nephrol. 2015;47(11):1801-7.
Musso, C. G., Jauregui, J. R., & Macías Núñez, J. F. (2015). Frailty phenotype and chronic kidney disease: a review of the literature. International Urology and Nephrology, 47(11), 1801-7. https://doi.org/10.1007/s11255-015-1112-z
Musso CG, Jauregui JR, Macías Núñez JF. Frailty Phenotype and Chronic Kidney Disease: a Review of the Literature. Int Urol Nephrol. 2015;47(11):1801-7. PubMed PMID: 26411428.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Frailty phenotype and chronic kidney disease: a review of the literature. AU - Musso,Carlos G, AU - Jauregui,Jose R, AU - Macías Núñez,Juan F, Y1 - 2015/09/28/ PY - 2015/06/06/received PY - 2015/09/14/accepted PY - 2015/9/29/entrez PY - 2015/9/29/pubmed PY - 2016/8/24/medline KW - Chronic kidney disease KW - Dialysis KW - Elderly KW - Frailty phenotype SP - 1801 EP - 7 JF - International urology and nephrology JO - Int Urol Nephrol VL - 47 IS - 11 N2 - Frailty is a construct originally coined by gerontologists to describe cumulative declines across multiple physiological systems that occur with aging and lead individuals to a state of diminished physiological reserve and increased vulnerability to stressors. Fried et al. provided a standardized definition for frailty, and they created the concept of frailty phenotype which incorporates disturbances across interrelated domains (shrinking, weakness, poor endurance and energy, slowness, and low physical activity level) to indentify old people who are at risk of disability, falls, institutionalization, hospitalization, and premature death. Some authors consider the presence of lean mass reduction (sarcopenia) as part of the frailty phenotype. The frailty status has been documented in 7 % of elderly population and 14 % of not requiring dialysis CKD adult patients. Sarcopenia increases progressively along with loss of renal function in CKD patients and is high in dialysis population. It has been documented that prevalence of frailty in hemodialysis adult patients is around 42 % (35 % in young and 50 % in elderly), having a 2.60-fold higher risk of mortality and 1.43-fold higher number of hospitalization, independent of age, comorbidity, and disability. The Clinical Frailty Scale is the simplest and clinically useful and validated tool for doing a frailty phenotype, while the diagnosis of sarcopenia is based on muscle mass assessment by body imaging techniques, bioimpedance analysis, and muscle strength evaluated with a handheld dynamometer. Frailty treatment can be based on different strategies, such as exercise, nutritional interventions, drugs, vitamins, and antioxidant agents. Finally, palliative care is a very important alternative for very frail and sick patients. In conclusion, since the diagnosis and treatment of frailty and sarcopenia is crucial in geriatrics and all CKD patients, it would be very important to incorporate these evaluations in pre-dialysis, peritoneal dialysis, hemodialysis, and kidney transplant patients in order to detect and consequently treat the frailty phenotype in these groups. SN - 1573-2584 UR - https://www.unboundmedicine.com/medline/citation/26411428/Frailty_phenotype_and_chronic_kidney_disease:_a_review_of_the_literature_ DB - PRIME DP - Unbound Medicine ER -