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Abstract: PO1223

Polypharmacy and Frailty Among Hemodialysis Patients

Session Information

Category: Dialysis

  • 701 Dialysis: Hemodialysis and Frequent Dialysis

Authors

  • Kimura, Hiroshi, Harold Simmons Center for Kidney Disease Research and Epidemiology, Orange, California, United States
  • Sy, John, Harold Simmons Center for Kidney Disease Research and Epidemiology, Orange, California, United States
  • Rhee, Connie, Harold Simmons Center for Kidney Disease Research and Epidemiology, Orange, California, United States
  • Streja, Elani, Harold Simmons Center for Kidney Disease Research and Epidemiology, Orange, California, United States
  • Kalantar-Zadeh, Kamyar, Harold Simmons Center for Kidney Disease Research and Epidemiology, Orange, California, United States
Background

Most patients undergoing maintenance dialysis have multiple comorbidities, most of which require long term medication management and can inevitably lead to polypharmacy. Frailty is also highly prevalent among dialysis patients and has been associated with poor outcomes. With higher frailty and comorbidity rates among dialysis patients, it remains unclear if polypharmacy is still associated with the incidence of frailty among dialysis patients. The aim of this study was to examine the independent association between polypharmacy and frailty among hemodialysis patients.

Methods

We examined 337 patients enrolled in the ACTIVE/ADIPOSE dialysis cohort study. The number of prescribed medications and frailty were assessed at baseline, 12, and 24 months. We used logistic regression with generalized estimating equations to model the association of the number of medications and frailty over time; competing-risks regression to assess incidence of frailty.

Results

The mean number of medications was 10 ± 5, and 94 patients (28%) were frail at baseline. Patients taking greater than 11 medications showed higher odds for frailty as compared with patients taking less than 8 medications (OR 1.54, 95% CI 1.05-2.26). During two years of follow-up, 87 patients developed frailty among the non-frail patients at baseline. Compared with patients taking less than 8 medications, the incidence of frailty was approximately 2-fold in those taking greater than 11 medications (sub-distribution hazard ratio [SHR] 2.15, 95% CI 1.32-3.48).

Conclusion

Using a higher number of medications was associated with frailty and the incidence of frailty among hemodialysis patients. Minimizing polypharmacy may reduce the incidence and prevalence of frailty among dialysis patients.