Factors associated with frailty in patients on renal replacement therapy with dialysis. A systematic review

Abstract

Introduction: Frailty is a multidimensional syndrome characterized by a decrease in physiological reserves, lean body mass, weakness and decreased resistance to physical exercise. It places the person in a situation of greater vulnerability to external factors, in addition there is a close relationship between frailty and chronic diseases, such as renal insufficiency chronic. Objective: The main objective of this review was to synthesize and know the scientific evidence on the factors associated with the frailty of patients with renal insufficiency chronic in renal replacement therapy with dialysis. Material and Method: A systematic review was carried out using the PubMed and ProQuest databases. Original articles in English and Spanish published between 2015 and 2020 were included, and articles dealing with frailty in patients with renal disease on renal replacement therapy were analysed. Articles that did not present results were excluded. Results: 27 observational design articles were included. The findings focus on prevalence, mortality, hospitalization rate, disability, cognitive decline, depressive symptoms, obesity, comorbidities, falls or fractures, and physical activity. Conclusions: A high prevalence of frailty has been found in the chronic renal patient in replacement therapy with dialysis, without differences between peritoneal dialysis and hemodialysis. Frailty in these patients is associated with higher mortality, hospitalization rate, disability, cognitive decline, depressive symptoms and comorbidities. Physical activity and performance appear to be factors that decrease frailty.