Current situation and influencing factors of frailty in elderly maintenance hemodialysis patients

SHI Yun; LI Xin; YAN Ting

doi:10.12102/j.issn.2095-8668.2025.24.020

Abstract：Objective: To investigate the current status of frailty in elderly patients on maintenance hemodialysis and its influencing factors, providing a reference for reducing the occurrence of frailty in this population. Methods: A convenience sampling method was used to select 286 elderly patients on maintenance hemodialysis admitted to our hospital from July 2022 to December 2023. These patients were divided into a modeling group (n=200) and a validation group (n=86) at a ratio of 7:3. According to whether frailty occurred, the modeling group was further divided into the frail group and non-frail group. Univariate and multivariate logistic regression analyses were conducted to identify the influencing factors of frailty in elderly patients on maintenance hemodialysis. Based on these factors, a risk prediction model for frailty was constructed and its predictive accuracy was validated. Results: Among the 200 elderly patients on maintenance hemodialysis in the modeling group, 78 developed frailty, with a prevalence rate of 39.00%. In the frailty screening scale scores of the modeling group, the highest scoring items were fatigue (57.00%) and resistance (44.00%). Multivariate logistic regression analysis showed that abnormal 4-meter gait speed, weekly exercise status, grip strength, nutritional risk, comorbid sarcopenia, depression, and social support were significant influencing factors of frailty in elderly patients on maintenance hemodialysis (P<0.05). The resulting frailty risk prediction model had an area under the receiver operating characteristic (ROC) curve (AUC) of 0.891 [95% CI (0.858, 0.925)], with an optimal cutoff value of 0.529, a specificity of 90.2%, and a sensitivity of 78.7%. Calibration curves showed good internal consistency between the model's predictions and expected outcomes, with a prediction accuracy of 86.05%. Conclusion: Abnormal 4-meter gait speed, depression, nutritional risk, and comorbid sarcopenia are independent risk factors for frailty in patients on maintenance hemodialysis, while weekly exercise status, grip strength, and social support are protective factors. The frailty risk prediction model constructed based on these factors has certain predictive value for the occurrence of frailty in elderly patients on maintenance hemodialysis, and can provide reference for early clinical intervention.