Analysis of the influencing factors of frailty in maintenance hemodialysis patients and its correlation with sleep_West China Medical Journal

Authors：

GAO Menglin , ZENG Ying , WANG Xue , YANG Yujie ,  YUAN Huaihong

Department of Nephrology, West China Hospital, Sichuan University / West China School of Nursing, Sichuan University, Chengdu, Sichuan 610041, P. R. China;

Corresponding?author：

YUAN Huaihong, Email: yuanhuaihong@wchscu.cn

Keywords：

Maintenance hemodialysis; Pittsburgh Sleep Quality Index; frail; influencing factors; correlation

DOI：

10.7507/1002-0179.202106180

Video：

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Objective To understand the incidence of frailty in maintenance hemodialysis (MHD) patients, and to explore the correlation and influencing factors of frailty in MHD patients, so as to provide some basis for the intervention of frailty in MHD patients. Methods Patients who underwent MHD in the Department of Nephrology of West China Hospital of Sichuan University from January to March 2021 were selected. Frail scale and Pittsburgh Sleep Quality Index (PSQI) were used for evaluation, and the influencing factors of frail in patients with MHD and its correlation with frail were analyzed. Results A total of 141 patients with MHD were included, including 57 cases without frailty (40.43%), 71 cases in early frailty (50.35%), and 13 cases in frailty (9.22%). 54 cases (38.30%) had very good sleep quality, 56 cases (39.72%) had good sleep quality, 24 cases (17.02%) had average sleep quality, and 7 cases (4.96%) had very poor sleep quality. The frailty of MHD patients was positively correlated with age (r_s=0.265, P=0.002), PSQI (r_s=0.235, P=0.005) and magnesium (r_s=0.280, P=0.001). Logistic regression analysis showed that the influencing factors of MHD patients’ frailty were gender [odds ratio (OR) =4.321, 95%confidence interval (CI) (1.525, 12.243), P=0.006], PSQI [OR=1.110, 95%CI (1.009, 1.222), P=0.032], magnesium [OR=122.072, 95%CI (4.752, 3 135.528), P=0.004], hypertension [OR=0.112, 95%CI (0.023, 0.545), P=0.007] and other diseases [OR=0.102, 95%CI (0.019, 0.552), P=0.008]. Conclusions The incidence of frailty in MHD patients is high. Gender, PSQI, magnesium, hypertension and other diseases are the influencing factors of frailty in MHD patients, and there is a correlation between frailty and sleep. It is suggested that renal medical staff should pay more attention to the assessment of MHD frailty and sleep, and carry out multi-disciplinary personalized intervention to improve the quality of life of MHD patients.

Citation： GAO Menglin, ZENG Ying, WANG Xue, YANG Yujie, YUAN Huaihong. Analysis of the influencing factors of frailty in maintenance hemodialysis patients and its correlation with sleep. West China Medical Journal, 2022, 37(2): 242-247. doi: 10.7507/1002-0179.202106180 Copy

1.	Ling TW, Khuan L, Baharom A, et al. Coping strategies of patients with end stage kidney disease on hemodialysis: a systematic review. Nephrol Nurs J, 2021, 48(1): 31-48.
2.	Nitta K, Hanafusa N, Tsuchiya K. Role of frailty on outcomes of dialysis patients. Contrib Nephrol, 2018, 195: 102-109.
3.	Wennberg AMV, St Louis EK. Interconnectedness among frailty, sleep, and cognition: recent findings and clinical implications. Int Psychogeriatr, 2019, 31(6): 763-766.
4.	蔡康琴, 李偉, 王莉, 等. 血液透析患者衰弱現狀的調查研究. 護理學雜志, 2019, 34(11): 24-27.
5.	Buysse DJ, Reynolds CF 3rd, Monk TH, et al. The Pittsburgh Sleep Quality Index: a new instrument for psychiatric practice and research. Psychiatry Res, 1989, 28(2): 193-213.
6.	李九紅, 黃伶智, 任小紅, 等. 維持性血液透析患者癥狀困擾與睡眠質量和生活質量的相關性研究. 中國護理管理, 2016, 16(1): 25-29.
7.	Chowdhury R, Peel NM, Krosch M, et al. Frailty and chronic kidney disease: a systematic review. Arch Gerontol Geriatr, 2017, 68: 135-142.
8.	Takeuchi H, Uchida HA, Kakio Y, et al. The prevalence of frailty and its associated factors in Japanese hemodialysis patients. Aging Dis, 2018, 9(2): 192-207.
9.	陳琰, 鄭淑蓓, 鄭育, 等. 維持性血液透析患者的衰弱情況及其影響因素. 中華腎臟病雜志, 2017, 33(10): 763-769.
10.	吳淑琳, 宋潔, 肖萍, 等. 維持性血液透析患者衰弱發生率及影響因素的系統評價. 中華護理教育, 2021, 18(4): 352-357.
11.	van Loon IN, Goto NA, Boereboom FTJ, et al. Frailty screening tools for elderly patients incident to dialysis. Clin J Am Soc Nephrol, 2017, 12(9): 1480-1488.
12.	趙敬娜, 羅莉, 蘇香彪, 等. 維持性血液透析患者嚴重睡眠障礙調查及原因分析. 中國血液凈化, 2019, 18(11): 783-786.
13.	劉美君, 崔文鵬, 苗里寧, 等. 維持性血液透析患者睡眠障礙的研究進展. 中國全科醫學, 2020, 23(29): 3712-3718, 3728.
14.	Pourmotabbed A, Boozari B, Babaei A, et al. Sleep and frailty risk:a systematic review and meta-analysis. Sleep Breath, 2020, 24(3): 1187-1197.
15.	李九紅, 黃伶智, 任小紅, 等. 中藥足浴對維持性血液透析患者睡眠質量和癥狀困擾的影響研究. 中國全科醫學, 2016, 19(10): 1207-1212.
16.	鄭偉, 李珊, 李亞新, 等. 住院老年患者衰弱與認知功能障礙的關系. 現代醫學, 2018, 46(3): 326-330.
17.	夏宇曉, 于紅靜, 周英, 等. 老年人衰弱研究新進展. 全科護理, 2019, 17(1): 20-23.
18.	Lu C, Wang Y, Wang D, et al. Hypomagnesemia and short-term mortality in elderly maintenance hemodialysis patients. Kidney Dis (Basel), 2020, 6(2): 109-118.
19.	Santiago LM, Gobbens RJJ, Mattos IE, et al. A comparison between physical and biopsychosocial measures of frailty: prevalence and associated factors in Brazilian older adults. Arch Gerontol Geriatr, 2019, 81: 111-118.
20.	Aprahamian I, Sassaki E, Dos Santos MF, et al. Hypertension and frailty in older adults. J Clin Hypertens (Greenwich), 2018, 20(1): 186-192.
21.	郭瀟瀟, 高靜, 向玉萍, 等. 老年 2 型糖尿病患者慢性并發癥與衰弱的關聯性研究. 中國療養醫學, 2019, 28(3): 225-229.
22.	王灣灣, 李園園, 石小天, 等. 老年住院患者衰弱的影響因素分析及其與營養不良的相關性研究. 中國全科醫學, 2021, 24(6): 678-684.
23.	Tabara Y, Kohara K, Ochi M, et al. Association of office-based frailty score with hypertensive end organ damage in the J-SHIPP cross-sectional study. Int J Cardiol, 2016, 216: 25-31.

1. Ling TW, Khuan L, Baharom A, et al. Coping strategies of patients with end stage kidney disease on hemodialysis: a systematic review. Nephrol Nurs J, 2021, 48(1): 31-48.
2. Nitta K, Hanafusa N, Tsuchiya K. Role of frailty on outcomes of dialysis patients. Contrib Nephrol, 2018, 195: 102-109.
3. Wennberg AMV, St Louis EK. Interconnectedness among frailty, sleep, and cognition: recent findings and clinical implications. Int Psychogeriatr, 2019, 31(6): 763-766.
4. 蔡康琴, 李偉, 王莉, 等. 血液透析患者衰弱現狀的調查研究. 護理學雜志, 2019, 34(11): 24-27.
5. Buysse DJ, Reynolds CF 3rd, Monk TH, et al. The Pittsburgh Sleep Quality Index: a new instrument for psychiatric practice and research. Psychiatry Res, 1989, 28(2): 193-213.
6. 李九紅, 黃伶智, 任小紅, 等. 維持性血液透析患者癥狀困擾與睡眠質量和生活質量的相關性研究. 中國護理管理, 2016, 16(1): 25-29.
7. Chowdhury R, Peel NM, Krosch M, et al. Frailty and chronic kidney disease: a systematic review. Arch Gerontol Geriatr, 2017, 68: 135-142.
8. Takeuchi H, Uchida HA, Kakio Y, et al. The prevalence of frailty and its associated factors in Japanese hemodialysis patients. Aging Dis, 2018, 9(2): 192-207.
9. 陳琰, 鄭淑蓓, 鄭育, 等. 維持性血液透析患者的衰弱情況及其影響因素. 中華腎臟病雜志, 2017, 33(10): 763-769.
10. 吳淑琳, 宋潔, 肖萍, 等. 維持性血液透析患者衰弱發生率及影響因素的系統評價. 中華護理教育, 2021, 18(4): 352-357.
11. van Loon IN, Goto NA, Boereboom FTJ, et al. Frailty screening tools for elderly patients incident to dialysis. Clin J Am Soc Nephrol, 2017, 12(9): 1480-1488.
12. 趙敬娜, 羅莉, 蘇香彪, 等. 維持性血液透析患者嚴重睡眠障礙調查及原因分析. 中國血液凈化, 2019, 18(11): 783-786.
13. 劉美君, 崔文鵬, 苗里寧, 等. 維持性血液透析患者睡眠障礙的研究進展. 中國全科醫學, 2020, 23(29): 3712-3718, 3728.
14. Pourmotabbed A, Boozari B, Babaei A, et al. Sleep and frailty risk:a systematic review and meta-analysis. Sleep Breath, 2020, 24(3): 1187-1197.
15. 李九紅, 黃伶智, 任小紅, 等. 中藥足浴對維持性血液透析患者睡眠質量和癥狀困擾的影響研究. 中國全科醫學, 2016, 19(10): 1207-1212.
16. 鄭偉, 李珊, 李亞新, 等. 住院老年患者衰弱與認知功能障礙的關系. 現代醫學, 2018, 46(3): 326-330.
17. 夏宇曉, 于紅靜, 周英, 等. 老年人衰弱研究新進展. 全科護理, 2019, 17(1): 20-23.
18. Lu C, Wang Y, Wang D, et al. Hypomagnesemia and short-term mortality in elderly maintenance hemodialysis patients. Kidney Dis (Basel), 2020, 6(2): 109-118.
19. Santiago LM, Gobbens RJJ, Mattos IE, et al. A comparison between physical and biopsychosocial measures of frailty: prevalence and associated factors in Brazilian older adults. Arch Gerontol Geriatr, 2019, 81: 111-118.
20. Aprahamian I, Sassaki E, Dos Santos MF, et al. Hypertension and frailty in older adults. J Clin Hypertens (Greenwich), 2018, 20(1): 186-192.
21. 郭瀟瀟, 高靜, 向玉萍, 等. 老年 2 型糖尿病患者慢性并發癥與衰弱的關聯性研究. 中國療養醫學, 2019, 28(3): 225-229.
22. 王灣灣, 李園園, 石小天, 等. 老年住院患者衰弱的影響因素分析及其與營養不良的相關性研究. 中國全科醫學, 2021, 24(6): 678-684.
23. Tabara Y, Kohara K, Ochi M, et al. Association of office-based frailty score with hypertensive end organ damage in the J-SHIPP cross-sectional study. Int J Cardiol, 2016, 216: 25-31.

West China Medical Journal

Analysis of the influencing factors of frailty in maintenance hemodialysis patients and its correlation with sleep

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