Frailty in hemodialysis patients: results of a screening program and multidisciplinary interventions

ABSTRACT Background The number of frail patients advanced age with end-stage kidney disease (ESKD) undergoing hemodialysis is increasing globally. Here we evaluated a frailty screening program ESKD starting hemodialysis, and subsequent multidisciplinary interventions. Methods This was prospective observational study in program. Patients were for (Fried phenotype) before after 12-month period. followed standard clinical practice at our hospital, which included assessment interventions nutritional (malnutrition-inflammation score, protein-energy wasting), physical [short performance battery (SPPB)] psychological status. Results A total 167 (mean ± deviation 67.8 15.4 years) screened frailty, 108 completed the At screening, 27.9% frail, 40.0% pre-frail 32.1% non-frail. Nutritional (enrichment, oral supplements, intradialytic parenteral nutrition) resulted stable status most 12 months. following recommendations intradialytic, home-based or combined exercise presented improved SPPB scores months, compared those that did not follow recommendations, especially population (P = .025). rate 0.05 falls/patient/year observed. More than 60% high sadness anxiety. Conclusions Frailty together coordinated by nutritionists, physiotherapists, psychologists nurses, preserved health hemodialysis. helped advising on individual nutritional, needs.