Influence of Frailty on Health-Related Quality of Life Trajectories in Chronic Kidney Disease Patients in India

Abstract

Background: Frailty is a critical concern for chronic kidney disease (CKD) patients, contributing to increased vulnerability to adverse health outcomes and diminished quality of life. However, there is limited research on frailty’s impact on health-related quality of life (HRQOL) among dialysis and pre-dialysis patients in the Indian context. Methods: This study involved participants aged 18 and above with CKD stages 3–5. Frailty was assessed using the Morley FRAIL questionnaire, and HRQOL was measured using the RAND version of the KDQOL-36 Survey. Data were analyzed with SPSS version 29, focusing on the association between frailty and HRQOL domains. Results: Among the 147 CKD patients, 56.46% were frail, and 43.56% were non-frail. Significant differences were noted between frail and non-frail groups in age (p = 0.036), CKD stages (p < 0.001), nutritional status (p < 0.001), Charlson comorbidity index (p < 0.001), BMI (p < 0.001), GFR (p < 0.001), CRP (p = 0.006), and serum albumin (p = 0.002). Frailty is significantly associated with lower physical (p < 0.001) and mental (p < 0.001) quality of life. Negative associations between frailty and KDQOL-36 domains, especially symptom problems, PCS, and MCS, were established. Conclusions: Our findings emphasize the importance of frailty screening in CKD patients. Early identification may help guide targeted strategies to support HRQOL. However, longitudinal studies are needed to assess frailty progression and the impact of potential interventions.