International Urology and Nephrology

, Volume 52, Issue 1, pp 115–120 | Cite as

The prevalence of frailty in patients on hemodialysis: a systematic review and meta-analysis

  • Yaxi Zhao
  • Qinyu Liu
  • Jie JiEmail author
Nephrology - Review



Coexistence of frailty and hemodialysis is related to higher risk of hospitalization, falls and mortality. Given the potential reversibility of frailty, reaching the epidemiology of frailty in hemodialysis is of great importance. However, estimates of the prevalence of frailty in patients on hemodialysis vary widely. We tried to synthesize the existing body of literature on the prevalence of frailty in patients on hemodialysis.


We searched Pubmed, Embase, Web of Science and Cochrane for studies of the prevalence in patients on hemodialysis. The prevalence of frailty was synthesized across eligible studies using a random-effects model. We explored potential origin of heterogeneity in the estimates by meta-regression analysis.


Prevalence range from 6.0 to 82.0% and the pooled prevalence of frailty in patients on dialysis was 34.3% (95% confidence interval (CI) 24.5–44.1%; z = 6.87; p = 0.00). The pooled estimates of prevalence for patients aged < 55, 55–65, and ≥ 65 were 56.0% (95% CI 28.9–83.2%; z = 4.04; p = 0.00), 32.3% (95% CI 22.9–41.7%; z = 6.74; p = 0.00), and 20.3% (95% CI 7.9–32.8%; z = 3.2; p = 0.00), respectively. There were no significant relationships between frailty in hemodialysis and factors such as years of publication, sample size (continuous), sample size(> 500 vs ≤ 500), diagnostic method (the Fried Frailty vs other), country (Europe & USA vs Asia) and duration of hemodialysis.


Frailty influences almost three in ten patients on hemodialysis. Understanding the underlying pathophysiology mechanisms and weakening the impacts of frailty in patients on hemodialysis are called on to action in the future work.


Frailty Hemodialysis Geriatric prevalence Meta-analysis 




Compliance with ethical standards

Conflict of interest

The authors of this article declare that they have no conflict of interest.

Ethical approval

This article does not contain any studies with human participants or animals performed by any of the authors.

Informed consent

Informed consent was obtained from all individual participants included in the study.


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Copyright information

© Springer Nature B.V. 2019

Authors and Affiliations

  1. 1.The Center of Gerontology and GeriatricsWest China Hospital, Sichuan UniversityChengduPeople’s Republic of China
  2. 2.National Clinical Research Center for GeriatricsChengduPeople’s Republic of China
  3. 3.Department of Urology, Institute of Urology (Laboratory of Reconstructive Urology), West China HospitalSichuan UniversityChengduPeople’s Republic of China
  4. 4.Department of Hematology and Hematological Research Laboratory, West China HospitalSichuan UniversityChengduPeople’s Republic of China

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