Abstract
BackgroundDepression and frailty contribute to the adverse clinical outcome of peritoneal dialysis (PD) patients. However, the interaction between depression and frailty in PD patients remains uncertain. We determined the prevalence of depression and frailty in prevalent Chinese PD patients, dissected the internal relationship between depression and frailty, and determined their relative contribution to the adverse clinical outcome in PD patients.MethodsIn a prospective observational study, we recruited 267 prevalent PD patients. Depression was identified by Patient Health Questionnaire (PHQ-9). Frailty was identified by a validated Frailty Score. All cases were followed for one year. Outcome measures included number and duration of hospitalization, peritonitis rate, and all-cause mortality.ResultsOf the 267 patients, 197 patients (73.8%) were depressed, and 157 (58.8%) were frail. There was a substantial overlap between depression and frailty. Although depression and frailty were associated the number and duration of hospitalization by univariate analysis, the association became insignificant after adjusting for confounding factors by multivariate analysis. Both depression and frailty were associated with one-year mortality by univariate analysis. One-year patient survival was 95.9, 86.5, 82.4 and 71.0% for patients with nil, mild, moderate and severe frailty, respectively (p = 0.001). Frailty was an independent predictor of patient survival by multivariate analysis (adjusted hazard ratio 1.424, 95% confidence interval 1.011–2.005. p = 0.043), while the prognostic effect of depression disappears after adjusting for frailty score.ConclusionDepression and frailty were common among Chinese PD patients. Frailty, but not depression, was an independent predictor of one-year mortality.
Highlights
Depression and frailty contribute to the adverse clinical outcome of peritoneal dialysis (PD) patients
As for the severity of frailty according to the Frailty Score (FQ), patients (27.3%) were classified as not frail, (27.7%) mildly frail, 51 (19.1%) moderately frail, and 69 (25.8%) severely frail
There was a significant correlation between the Frailty Score and Charlson comorbidity score (r = 0.674, p < 0.0001)
Summary
Study population We recruited 267 prevalent PD patients from a single dialysis unit between 2015 and 2016. The primary outcomes of this study included the number of hospitalization and total duration of. Patients were grouped according to the degree of depression and frailty as defined above for analysis. Baseline clinical parameters between depression and frailty groups were compared by Kendall’s tau test and Spearman rank order correlation coefficient as appropriate, with post hoc subgroup analysis, when needed, by Student’s t-test or one way analysis of variance (ANOVA) for continuous variables, and Chi-square test for categorical variables. In addition to the degree of frailty and depression being added separately, the Cox models were constructed by similar clinical parameters used in the analysis of hospitalization. These parameters were selected because of their reported significance in determining the prognosis of PD patients.
Sign-in/Register to view highlights & summary Talk to us
Join us for a 30 min session where you can share your feedback and ask us any queries you have
Schedule a callDisclaimer: All third-party content on this website/platform is and will remain the property of their respective owners and is provided on "as is" basis without any warranties, express or implied. Use of third-party content does not indicate any affiliation, sponsorship with or endorsement by them. Any references to third-party content is to identify the corresponding services and shall be considered fair use under The CopyrightLaw.
