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The prevalence and influencing factors of frailty in patients with chronic kidney disease: a systematic review and meta-analysis

  • Nephrology - Original Paper
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Abstract

Background

To investigate the prevalence and influencing factors of frailty and pre-frailty in chronic kidney disease (CKD) patients and thereby provide a scientific basis for effective avoidance of frailty in patients with CKD.

Methods

PubMed, EMBASE, Web of Science, EBSCO, Cochrane Library, CNKI, VIP, CBMdisc, and Wanfang databases were searched for relevant studies published till December 31, 2021. The summary results were described as odds ratios (ORs) or standardized mean differences (SMDs) with 95% confidence intervals (CIs). A meta-analysis was performed using StataSE12.0.

Results

Fifteen published studies, which enrolled a total of 3294 CKD patients, met the inclusion criteria. The combined prevalence of frailty in CKD patients was 38.1% (95% CI 29.7–46.5%) and pre-frailty was 37.9% (95% CI 32.7–43.1%). The main factors influencing frailty in CKD patients were age (SMD 0.524, 95% CI 0.326–0.723), diastolic blood pressure (SMD − 0.294, 95% CI − 0.518 to − 0.071), body mass index (BMI) (SMD − 0.267, 95% CI − 0.471 to − 0.064), grip strength (SMD − 0.929, 95% CI − 1.233 to − 0.626), hemoglobin level (SMD − 0.346, 95% CI − 0.448 to − 0.243), serum albumin level (SMD − 0.533, 95% CI − 0.655 to − 0.411), Charlson Comorbidity Index (SMD 0.421, 95% CI 0.150–0.692), multiple medications (SMD 0.625, 95% CI 0.354–0.895), Mini-Mental State Examination (MMSE) score (SMD − 0.563, 95% CI − 0.846 to − 0.280), and female (OR 2.391, 95% CI 1.236–4.627).

Conclusion

Frailty is common in CKD patients. The prevalence of frailty among CKD patients was related to age, diastolic blood pressure, BMI, grip strength, hemoglobin and serum albumin levels, Charlson Comorbidity Index, multiple medications, MMSE score, and female.

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Data availability

The data that support the findings of this study are available from the corresponding author upon reasonable request.

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Acknowledgements

The authors would like to thank all researchers who participated in this meta-analysis.

Funding

This work was supported by the provincial project of Undergraduate Innovation and Entrepreneurship Training Program of Anhui Medical University in 2021 [grant number S202110366100] and a grant from the Seedling cultivation programme of the School of Nursing, Anhui Medical University in 2023 [grant number hlqm12023043].

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Author notes

  1. Bo-Han Li, Ni Sang, Meng-Yao Zhang and Zhi-Rou Liu have contributed equally to this paper and should be considered co-first authors.

Authors and Affiliations

  1. School of Nursing, Anhui Medical University, 15 Feicui Road, Hefei, 230032, Anhui, China

    Bo-Han Li, Ni Sang, Meng-Yao Zhang, Zhi-Rou Liu, Ruo-Xuan Fang, Wen-Jing Liu & Guo-Cui Wu

  2. Department of Nephrology, The Second Hospital of Anhui Medical University, Hefei, 230601, Anhui, China

    De-Guang Wang

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Contributions

All authors contributed to the study conception and design. Material preparation, data collection and analysis were performed by B-HL, NS, M-YZ, Z-RL, D-GW and G-CW. Carried out the conversion of the data were performed by R-XF and W-JL. The first draft of the manuscript was written by B-HL and all authors commented on previous versions of the manuscript. Revised manuscripts were performed by D-GW and G-CW. All authors read and approved the final manuscript. None of the authors reported a conflict of interest related to the study.

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Correspondence to De-Guang Wang or Guo-Cui Wu.

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Li, BH., Sang, N., Zhang, MY. et al. The prevalence and influencing factors of frailty in patients with chronic kidney disease: a systematic review and meta-analysis. Int Urol Nephrol 56, 767–779 (2024). https://doi.org/10.1007/s11255-023-03739-2

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