The relationship between frailty and nutritional status, inflammation, and quality of life in hemodialysis patients

This study was conducted to determine frailty, inflammation, quality of life and nutritional status in patients receiving hemodialysis treatment and to examine the relationship between frailty and other factors. This study was conducted between April-June 2021 in the hemodialysis centers affiliated to the Çorum Provincial Health Directorate of the Ministry of Health with 139 hemodialysis patients (61 women, 78 men) aged over 20 years who had not previously undergone kidney transplantation and volunteered to participate in the study. The questionnaire, consisting of questions including demographic information, general habits, nutritional habits, comorbid diseases, family and care status, and information about hemodialysis treatment, was administered to all patients by face-to-face interview method. The anthropometric measurements of the patients were measured and recorded by the researcher, and the biochemical findings were taken from the patient files. Frailty status were evaluated with the Edmonton Frailty Scale, nutritional status were evaluated with the Seven-Score Subjective Global Assessment (SGD-7P), malnutrition-inflammation status were evaluated with the Malnutrition Inflammation Score (MIS) and C-Reactive Protein (CRP), quality of life was evaluated with the Short Form-12 (SF-12). The mean age of the patients was 61.6 ± 12.92 years. According to Edmonton Frailty Scale classification 32.4% were non-frail, 19.4% were apparent vulnerable, 48.2% were severe frail. Women were found to be statistically significantly higher score than that of men (p<0.05). According to the SGD-7P scale classification, 48.2% of the patients were found to have mild to moderate malnutrition and 6.5% to have severe malnutrition. Mean MIS score was 9.2 ± 4.22, mean C-Reactive Protein (CRP) value was 8.5 ± 13.36 mg/L. Age, height, serum creatinine, serum albumin and total iron binding capacity were found to be statistically significant according to fraility groups (p<0.05). The 57.1% of severe frailty patients were determined as mild-moderate malnutrition and 42.9% of them were severely malnourished. It was observed that the frequency of malnourished patients increased statistically as frailty level increased (p<0.05) and a moderately statistically positive significant relationship (r:0.428, p<0.05) was found. A moderately statistically significant negative correlation was found between frailty distribution of patients and their quality of life (r:-0.469, p<0.05). In conclusion, hemodialysis patients are at risk for frailty, malnutrition, inflammation and poor quality of life. It is of great importance to routinely screen all these factors in these patients and to plan treatments for these risk factors. Key Words: Hemodialysis, frailty, nutritional status, malnutrition, inflammation, quality of life