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Abstract: TH-PO250

Frailty, Age, and Post-Dialysis Recovery Time in an Incident Hemodialysis Population

Session Information

Category: Dialysis

  • 701 Dialysis: Hemodialysis and Frequent Dialysis

Authors

  • Fitzpatrick, Jessica, The Hospital for Sick Children, Toronto, Ontario, Canada
  • Sozio, Stephen M., Johns Hopkins University, Baltimore, Maryland, United States
  • Jaar, Bernard G., Johns Hopkins University, Baltimore, Maryland, United States
  • Estrella, Michelle M., University of California, San Francisco and San Francisco VA Medical Center, San Francisco, California, United States
  • Segev, Dorry L., Johns Hopkins University, Baltimore, Maryland, United States
  • Monroy-Trujillo, Jose Manuel, Johns Hopkins University, Baltimore, Maryland, United States
  • Parekh, Rulan S., The Hospital for Sick Children, Toronto, Ontario, Canada
  • McAdams-DeMarco, Mara, Johns Hopkins University, Baltimore, Maryland, United States
Background

Frailty, a phenotype characterized by an inability to recover from a stressor, may help identify incident hemodialysis patients at risk for longer recovery time. Recovery time has been associated with downstream outcomes including quality of life and mortality. We characterize post-dialysis recovery times in incident in-center hemodialysis patients and quantify the association of frailty and recovery time.

Methods

In 285 incident hemodialysis patients enrolled in the Predictors of Arrhythmic and Cardiovascular Risk in End Stage Renal Disease (PACE) study, frailty was classified by the Fried phenotype as non-frail, intermediately frail, or frail. Post-dialysis recovery time was assessed by asking, “How long does it take you to recover from a dialysis session?” We estimated the association of frailty and post-dialysis self-reported recovery time using negative binomial regression after adjusting for clinical confounders.

Results

Mean age was 55 years, 24% were >65 years, and 73% were African American. Median recovery time was 20 min (IQR: 10, 120). Age <65 was independently associated with longer recovery time (IRR 2.36; 95%CI: 1.44-3.85). Intermediate frailty and frailty were associated with 2.56-fold (95%CI: 1.45-4.52) and 1.72-fold (95%CI: 1.03-2.89) longer recovery times. In particular, frail participants <65 were more likely to report longer recovery times (IRR 2.55; 95%CI: 1.46-4.43).[Figure] In non-frail participants, however, age was not associated with recovery time.

Conclusion

In adults initiating hemodialysis, frailty was independently associated with prolonged post-dialysis recovery. Future studies should assess the impact of frailty-targeted interventions on recovery time to improve clinical outcomes.

Funding

  • NIDDK Support