Interaction between central obesity and frailty on the clinical outcome of peritoneal dialysis patients

Interaction between central obesity and frailty on the clinical outcome of peritoneal dialysis patients

Background

Frailty is described by Fried et al. [1] as a clinical syndrome involving at least three of the following features: unintentional weight loss (10 lbs in one year), self-reported exhaustion, weakness (as determined by grip strength), slow walking speed, and low physical activity. It is highly prevalent among patients on dialysis, with a prevalence of up to 67.7% in previous report [2].

Physical frailty has important health consequences. Frail patients are more susceptible to the development of adverse outcomes when faced with a stressor. It also leads to a decline in physical function, gait disability, increase in the risks of fall. As a result, frail peritoneal dialysis (PD) patients have a higher hospitalization risk and their hospital stay tends to be prolonged [3]. Physical frailty is also a well-established independent predictor of adverse outcomes including mortality in pre-dialysis end stage renal disease patients [4], hemodialysis (HD) patients and PD patients [35].

Physical frailty causes alteration in body composition. Frail patients tend to suffer from obesity [69]. On the other hand, PD patients are more susceptible to central obesity [10] due to exposure to glucose-containing dialysate fluid. In contrast to general obesity, central obesity confers a worse survival in dialysis patients [11]. Previous study has shown synergistic effect on mortality between physical frailty and central obesity in HD patients. However, the interaction between physical frailty and body composition has not been explored.

 

Source: Journal Plos

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