title: The Prevalence, Association, and Clinical Outcomes of Frailty in Maintenance Dialysis Patients.
abstract: To investigate the clinical implications of frailty in chronic kidney disease patients undergoing maintenance hemodialysis and chronic peritoneal dialysis.
  
  
  
  In this prospective study, all of the participants completed the Short Form of the Kidney Disease Quality of Life questionnaire, Korean version, to determine their frailty phenotype. We also obtained blood chemistry and demographic data at enrollment. Data regarding the history of hospitalization and death were collected during the follow-up period.
  
  
  
  We recruited 1,658 patients (1,255 maintenance hemodialysis and 403 chronic peritoneal dialysis) from multidialysis units (n = 27). We excluded patients who had been hospitalized in the previous 3 months.
  
  
  
  Hospitalization and survival rate during study period.
  
  
  
  The participants' mean age was 55.2 ± 11.9 years old, and 55.2% were male. Among the participants, 34.8% were rated as frail and 45.7% as prefrail. Multivariate analysis demonstrated significant associations of frailty with age, comorbidity, disability, unemployment, higher body mass index, and a lower educational level. During the follow-up period (median 17.1 months), 608 patients (79 not frail, 250 prefrail, and 279 frail) were hospitalized, and 87 patients (10 not frail, 24 prefrail, and 53 frail) died (P < .001). Frailty was associated with hospitalization (adjusted hazard ratio, 1.80; 95% confidence interval: 1.38-2.36) and mortality (hazard ratio, 2.37, 95% confidence interval: 1.11-5.02).
  
  
  
  The frailty phenotype was common even in, prevalent end-stage renal disease patients on dialysis, and was significantly associated with higher rates of hospitalization and mortality.
authors.affiliation: Department of Internal Medicine, Division of Nephrology, CHA Bundang Medical Center, CHA University School of Medicine, Seongnam, South Korea.
authors.forename: So-Young
authors.initials: SY
authors.lastname: Lee
authors.affiliation: Department of Internal Medicine, Division of Nephrology, CHA Bundang Medical Center, CHA University School of Medicine, Seongnam, South Korea.
authors.forename: Dong Ho
authors.initials: DH
authors.lastname: Yang
authors.affiliation: Department of Internal Medicine, Division of Nephrology, Keimyung University School of Medicine, Daegu, South Korea.
authors.forename: Eunah
authors.initials: E
authors.lastname: Hwang
authors.affiliation: Department of Internal Medicine, Division of Nephrology, Yeungnam University Hospital, Daegu, South Korea.
authors.forename: Seock Hui
authors.initials: SH
authors.lastname: Kang
authors.affiliation: Department of Internal Medicine, Division of Nephrology, Kyungpook National University Hospital, Daegu, South Korea.
authors.forename: Sun-Hee
authors.initials: SH
authors.lastname: Park
authors.affiliation: Department of Internal Medicine, Division of Nephrology, Soonchunhyang University Gumi Hospital, Gumi, South Korea.
authors.forename: Tae Woo
authors.initials: TW
authors.lastname: Kim
authors.affiliation: Department of Internal Medicine, Division of Nephrology, Daegu Fatima Hospital, Daegu, South Korea.
authors.forename: Duk Hyun
authors.initials: DH
authors.lastname: Lee
authors.affiliation: Department of Preventive Medicine, School of Medicine Gyeongsang National University, Jinju, South Korea.
authors.forename: Kisoo
authors.initials: K
authors.lastname: Park
authors.affiliation: Department of Internal Medicine, Division of Nephrology, CHA Gumi Medical Center, CHA University, Gumi, South Korea. Electronic address: truedoc1@hanmail.net.
authors.forename: Jun Chul
authors.initials: JC
authors.lastname: Kim
mesh_terms: D000328:Adult; D000368:Aged; D015992:Body Mass Index; D015897:Comorbidity; D005260:Female; D005500:Follow-Up Studies; D000073496:Frailty / Q000175:diagnosis* / Q000453:epidemiology*; D006760:Hospitalization; D006801:Humans; D007676:Kidney Failure, Chronic / Q000453:epidemiology*; D008297:Male; D008875:Middle Aged; D010530:Peritoneal Dialysis / Q000009:adverse effects*; D015995:Prevalence; D011446:Prospective Studies; D011788:Quality of Life; D011795:Surveys and Questionnaires; D015996:Survival Rate