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Abstract: FR-PO659

Prevalence and Prognosis of Coexisting Frailty and Cognitive Impairment in Continuous Ambulatory Peritoneal Dialysis Patients: A Prospective Cohort Study from a Single Center in China

Session Information

Category: Dialysis

  • 703 Dialysis: Peritoneal Dialysis

Authors

  • Yi, Chunyan, The First Affiliated Hospital, Sun Yat-sen University, Guangzhou, Guangdong, China
  • Yang, Xiao, The First Affiliated Hospital, Sun Yat-sen University, Guangzhou, Guangdong, China
  • Yu, Xueqing, The First Affiliated Hospital, Sun Yat-sen University, Guangzhou, Guangdong, China
Background

The aim of this study was to investigate the prevalence of coexisting frailty and cognitive impairment as well as its association with clinical outcomes in continuous ambulatory peritoneal dialysis (CAPD) patients.

Methods

Patients on CAPD from January 1, 2014 and December 31, 2016 were recruited. Frailty was assessed by clinical frailty scale (CFS), and cognitive function was assessed by the Montreal Cognitive Assessment (MoCA). All patients were followed up until cessation of PD or December 31, 2017.

Results

A total of 880 CAPD patients were recruited, with a median vintage of PD 24.9 (6.0-52.4) months. The mean age was 48.5±14.6 years, 352 (40%) patients were female and 147 (26.7%) patients with diabetic nephropathy. Coexisting frailty and cognitive impairment was present in 205 (23.3%) patients. Pathway models showed that CFS score was negatively associated with MoCA score (β=-0.14, P<0.001); diabetes mellitus and cardiovascular disease are positively associated with CFS score (β=0.14, p<0.001; β=0.12, P<0.001) while negatively associated with MoCA score (β=-0.14, p<0.001; β=-0.08, P<0.01); serum albumin was negatively associated with CFS score (β=-0.09, P<0.01) while positively associated with MoCA score (β=0.05, P<0.05). Coexisting frailty and cognitive impairment was associated with increased mortality (HR 2.34; 95% CI 1.16-4.72; P<0.05) and had higher peritonitis rate (0.22 vs. 0.11 episodes per patient year, P<0.05).

Conclusion

Coexistence of frailty and cognitive impairment was common in CAPD patients, which increased the risk of adverse outcomes. A significant relationship between frailty and cognitive impairment was demonstrated.

Funding

  • Government Support - Non-U.S.