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Abstract: PO0842

Tuscany Network Program for Evaluation of Functional Status in Hemodialysis: The Rehabilitation in Hemodialysis Area Centro Tuscany (REACT) Study

Session Information

Category: Dialysis

  • 701 Dialysis: Hemodialysis and Frequent Dialysis

Authors

  • Capitanini, Alessandro, Nephrology and Dialysis Unit, USL Toscana Centro, Italy, Firenze, Italia, Italy
  • Ravaglia, Fiammetta, Nephrology and Dialysis Unit, USL Toscana Centro, Italy, Firenze, Italia, Italy
  • Spatoliatore, Giuseppe Lucian, Nephrology and Dialysis Unit, USL Toscana Centro, Italy, Firenze, Italia, Italy
  • Paci, Matteo, Nephrology and Dialysis Unit, USL Toscana Centro, Italy, Firenze, Italia, Italy
  • Pacini, Alessandro Md, Nephrology and Dialysis Unit, USL Toscana Centro, Italy, Firenze, Italia, Italy
  • Rosati, Alberto, Nephrology and Dialysis Unit, USL Toscana Centro, Italy, Firenze, Italia, Italy
Background

Frailty is associated with adverse outcomes among hemodialysis patients. Hemodialysis sessions may represent an opportunity to reassess functional status, to plan and monitor long-term physical exercise, leading to considerable improvement of quality of life and physical performance. The objective of our study is to assess the prevalence and predictors of frailty among a cohort of prevalent dialysis patients in our area (REACT Study).

Methods

A regional program was designed to evaluate functional status in all patients performing hemodialysis in the 11 Dialysis Units of USL Toscana Centro. All patients are screened through the following tests: Short Form Health Survey (SF12); Elderly Falls Screening Test; Short Physical Performance Battery (SPPB); Handgrip test. Patients were assigned to three groups on the basis of the SPPB score: poor (SPPB <6), moderate (SPPB 7-9) and good performers (SPPB >9).

Results

Of the 920 hemodialysis patients assessed for eligibility, 446 were enrolled and divided in 3 groups on the basis of SPPB score. Characteristics of the participants and functional status evaluation are shown in Table 1. SPPB score shows a significant correlation with handgrip of right arm (r=.248, p<0.001), with handgrip of left arm (r=.211, p<0.001), with Elderly Falls Screening Test (r=.448, p<0.001), with SF12 physical component (r=.432, p<0.001), with SF12 mental component (r=.146, p<0.001). Principal predictors of SPPB score are Elderly Falls Screening Test (adjusted R2=.235), and age (cumulative adjusted R2=.361).

Conclusion

In our hemodialysis population, SPPB allowed identification of 3 frailty phenotypes. The information needed to determine patients’ degree of frailty can be gathered relatively easily, making frailty assessment a routine activity in hemodialysis patients’ evaluation.

Table 1
VariablePoor performers (n=119)Moderate performers (n=119)Good performers (n=208)p value
Female sex – no. (%)57 (47.8)44 (36.9)76 (36.5) 
Age - yr75.1±9.872.4±1060.2±14.7 
Dialytic age - mo74.7±9.8972.4±9.9960.0±14.7 
SPPB score3.5±2.248.2±0.7911.2±0.87 
Handrip test - kg (right arm/left arm)20.9±10.9/19.1±11.424.8±14.1/23.2±13.730.5±15.1/26.8±14.6<0.001
Elderly Falls Screening Test - score2.3±1.41.2±1.60.7±1.0<0.001
SF12 physical score32.8±9.838.9±9.944.0±9.5<0.001
SF12 mental score46.0±12.346.9±12.049.2±11.20.45