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Frailty in Non-Dialysis ChronicKidney Disease

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Frailty and Kidney Disease

Abstract

Frailty status is a condition which is not merely induced by aging but mainly by a progressive and sustained deterioration of several body physiological processes that lead to an increased vulnerability to stressors. The prevalence of frailty is higher in older individuals with chronic kidney disease (CKD) compared to older people with normal renal function. Frailty prevalence increases with a worsened kidney function, which leads to an increase in falls, hospitalization, dialysis requirement, and mortality. CKD predisposes to frailty through many mechanisms, which can also lead to CKD progression. The coexistence of CKD and frailty phenotype has been considered a particular condition known as “senescent nephropathy,” since it is characterized by significant clinical complications, therapeutic demands, and worse prognosis, in comparison with robust older CKD patients. Frailty status trends should be identified since they represent an opportunity to successfully intervene by optimizing nutritional and rehabilitation efforts. The prevention or delay of the appearance of frailty and sarcopenia can be accomplished by low intensity resistance and aerobic physical exercise, caloric and protein intake, vitamin D supplementation, and avoidance of polypharmacy. In addition, these patients should also receive their corresponding CKD treatment, but even frailty evaluation can contribute to redesign the patient’s therapeutic objectives.

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References

  1. Nixon AC, Bampouras TM, Pendleton N, Mitra S, Dhaygude AP. Diagnostic accuracy of frailty screening methods in advanced chronic kidney disease. Nephron. 2019;141(3):147–55. https://doi.org/10.1159/000494223.

    Article  PubMed  Google Scholar 

  2. Coppolino G, Bolignano D, Gareri P, Ruberto C, Andreucci M, Ruotolo G, Rocca M, Castagna A. Kidney function and cognitive decline in frail elderly: two faces of the same coin? Int Urol Nephrol. 2018;50(8):1505–10. https://doi.org/10.1007/s11255-018-1900-3.

    Article  PubMed  Google Scholar 

  3. Ali H, Abdelaal F, Baharani J. Assessment of frailty in elderly pre-dialysis population using simple tools. Saudi J Kidney Dis Transpl. 2017;28(4):716–24.

    PubMed  Google Scholar 

  4. Ostuni M, Musso CG. Usefulness of frailty evaluation for handling chronic kidney disease elderly patients: a review and original proposal. Int Urol Nephrol. 2019;51(3):461–5. https://doi.org/10.1007/s11255-018-2061-0.

    Article  PubMed  Google Scholar 

  5. Demircioglu DT. The Association of Vitamin D levels and the frailty phenotype among non-geriatric dialysis patients: a cross-sectional study. Clinics (Sao Paulo). 2018;73:e116. https://doi.org/10.6061/clinics/2018/e116.

    Article  Google Scholar 

  6. Musso CG, Vilas M, Onuigbo M. Nephroprevention in the oldest old with chronic kidney disease: special considerations. World J Nephrol. 2015;4(1):1–5. https://doi.org/10.5527/wjn.v4.i1.1.

    Article  PubMed  PubMed Central  Google Scholar 

  7. Adame Perez SI, Senior PA, Field CJ, Jindal K, Mager DR. Frailty, health-related quality of life, cognition, depression, vitamin D and health-care utilization in an ambulatory adult population with type 1 or type 2 diabetes mellitus and chronic kidney disease: a cross-sectional analysis. Can J Diabetes. 2019;43(2):90–7. https://doi.org/10.1016/j.jcjd.2018.06.001.

    Article  PubMed  Google Scholar 

  8. Bohm CJ, Storsley LJ, Hiebert BM, Nelko S, Tangri N, Cheskin LJ, McAdams-DeMarco MA, Rigatto C. Impact of exercise counseling on physical function in chronic kidney disease: an observational study. Can J Kidney Health Dis. 2018;5:2054358117753615. https://doi.org/10.1177/2054358117753615.

    Article  PubMed  PubMed Central  Google Scholar 

  9. Van Pilsum Rasmussen S, Konel J, Warsame F, Ying H, Buta B, Haugen C, King E, DiBrito S, Varadhan R, Rodríguez-Mañas L, Walston JD, Segev DL, McAdams-DeMarco M. Engaging clinicians and patients to assess and improve frailty measurement in adults with end stage renal disease. BMC Nephrol. 2018;19(1):8. https://doi.org/10.1186/s12882-017-0806-0.

    Article  PubMed  PubMed Central  Google Scholar 

  10. 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. https://doi.org/10.1007/s11255-015-1112-z.

    Article  PubMed  Google Scholar 

  11. McAdams-DeMarco MA, Ying H, Thomas AG, Warsame F, Shaffer AA, Haugen C, Garonzik-Wang JM, Desai NM, Varadhan R, Walston J, Norman SP, Segev DL. Frailty, inflammatory markers, and waitlist mortality among patients with end-stage renal disease in a prospective cohort study. Transplantation. 2018;102(10):1740–6. https://doi.org/10.1097/TP.0000000000002213.

    Article  PubMed  PubMed Central  Google Scholar 

  12. Nixon AC, Bampouras TM, Pendleton N, Woywodt A, Mitra S, Dhaygude A. Frailty and chronic kidney disease: current evidence and continuing uncertainties. Clin Kidney J. 2018;11(2):236–45. https://doi.org/10.1093/ckj/sfx134.

    Article  PubMed  Google Scholar 

  13. Kittiskulnam P, Sheshadri A, Johansen K. Consequences of CKD on functioning. Semin Nephrol. 2016;36(4):305–18. https://doi.org/10.1016/j.semnephrol.2016.05.007.

    Article  PubMed  PubMed Central  Google Scholar 

  14. Kamijo, Kanda E, Ishibashi Y, Yoshida M. Sarcopenia and frailty in PD: impact on mortality, malnutrition, and inflammation. Perit Dial Int. 2018;38(6):447–54. https://doi.org/10.3747/pdi.2017.00271.

    Article  CAS  PubMed  Google Scholar 

  15. McAdams-DeMarco MA, Ying H, Olorundare I, King EA, Desai N, Dagher N, Lonze B, Montgomery R, Walston J, Segev DL. Frailty and health-related quality of life in end stage renal disease patients of all ages. J Frailty Aging. 2016;5(3):174–9.

    CAS  PubMed  PubMed Central  Google Scholar 

  16. Musso CG, Trigka K, Dousdampanis P, Jauregui J. Therapeutic alternatives and palliative care for advanced renal disease in the very elderly: a review of the literature. Int Urol Nephrol. 2015;47(4):647–54. https://doi.org/10.1007/s11255-014-0886-8.

    Article  PubMed  Google Scholar 

  17. Ortiz A, Sanchez-niño M. Sarcopenia in CKD: a roadmap from basic pathogenetic mechanisms to clinical trials. Clin Kidney J. 2019;12(1):110–2.

    Article  Google Scholar 

  18. Sieverdes JC, Rao V, Taber DJ, Noltemeyer Z, McGillicuddy JW, Bergamin M, Thangavel S, Baliga PK. Feasibility and functional testing for frailty in chronic kidney disease. Prog Transplant. 2018;28(3):299–300. https://doi.org/10.1177/1526924818781577.

    Article  PubMed  Google Scholar 

  19. Moffatt H, Moorhouse P, Mallery L, Landry D, Tennankore K. Using the Frailty Assessment for Care Planning Tool (FACT) to screen elderly chronic kidney disease patients for frailty: the nurse experience. Clin Interv Aging. 2018;13:843–52. https://doi.org/10.2147/CIA.S150673.

    Article  PubMed  PubMed Central  Google Scholar 

  20. Wawer AA, Jennings A, Fairweather-Tait SJ. Iron status in the elderly: a review of recent evidence. Mech Ageing Dev. 2018;175:55–73. https://doi.org/10.1016/j.mad.2018.07.003.

    Article  CAS  PubMed  Google Scholar 

  21. Formica M, Politano P, Marazzi F, Tamagnone M, Serra I, Marengo M, Falconi D, Gherzi M, Tattoli F, Bottaro C, Giuliano D, Tibaldi V, Isaia GC. Acute kidney injury and chronic kidney disease in the elderly and polypharmacy. Blood Purif. 2018;46(4):332–6. https://doi.org/10.1159/000492149.

    Article  CAS  PubMed  Google Scholar 

  22. Bansal AD, Leonberg-Yoo A, Schell JO, Scherer JS, Jones CA. Ten tips nephrologists wish the palliative care team knew about caring for patients with kidney disease. J Palliat Med. 2018;21(4):546–51. https://doi.org/10.1089/jpm.2018.0087.

    Article  PubMed  Google Scholar 

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Correspondence to Carlos G. Musso .

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Colombo, M., Musso-Enz, V.P., Romero, M.d.P., Aroca-Martinez, G., Musso, C.G. (2021). Frailty in Non-Dialysis ChronicKidney Disease. In: Musso, C.G., Jauregui, J.R., Macías-Núñez, J.F., Covic, A. (eds) Frailty and Kidney Disease. Springer, Cham. https://doi.org/10.1007/978-3-030-53529-2_11

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  • DOI: https://doi.org/10.1007/978-3-030-53529-2_11

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  • Publisher Name: Springer, Cham

  • Print ISBN: 978-3-030-53528-5

  • Online ISBN: 978-3-030-53529-2

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