We found a match
Your institution may have access to this item. Find your institution then sign in to continue.
- Title
Polypharmacy Predicts Onset and Transition of Frailty, Malnutrition, and Adverse Outcomes in Peritoneal Dialysis Patients.
- Authors
Chan, Gordon C.-K.; Ng, J. K.-C.; Chow, K.-M.; Cheng, P. M.-S.; Law, M.-C.; Leung, C.-B.; Li, P. K.-T.; Szeto, C.-C.
- Abstract
Background: Polypharmacy, frailty and malnutrition are known predictors of adverse outcomes in dialysis patients. Little has reported about their interaction and composite prognostic values. We aimed to describe the interaction between polypharmacy, frailty, nutrition, hospitalization, and survival in peritoneal dialysis patients. Methods: In this prospective cohort study, we recruited 573 peritoneal dialysis patients. Drug burden was measured by medication number and daily pill load. Frailty and nutrition were assessed by the validated Frailty Score (FQ) and Subjective Global Assessment (SGA) respectively. All patients were followed for two years. Primary outcome was all-cause mortality. Secondary outcomes were fall and fracture episodes, hospitalization, change in FQ and SGA. Results: At baseline, each patient took 7.5 ± 2.6 medications with 15.5 ± 8.5 tablets per day. Medication number, but not daily pill load predicted baseline FQ (p = 0.004) and SGA (p = 0.03). Over 2 years, there were 69 fall and 1,606 hospitalization episodes. In addition, 148 (25.8%) patients died, while FQ and SGA changed by 0.73 ± 4.23 and −0.07 ± 1.06 respectively in survivors. Medication number (hospitalization: p = 0.02, survival: p = 0.005), FQ (hospitalization: p < 0.001; survival: p = 0.01) predicted hospitalization and survival. Medication number also predicted fall episodes (p = 0.02) and frailty progression (p = 0.002). Daily pill load did not predict any of these outcomes. Conclusions: Drug burden is high in peritoneal dialysis patients, and it carries important prognostic implication. Medication number but not pill load significantly predicted onset and progression of frailty, malnutrition, fall, hospitalization, and mortality.
- Subjects
MORTALITY risk factors; FRAIL elderly; POLYPHARMACY; RISK assessment; TREATMENT effectiveness; AGE factors in disease; MALNUTRITION; ACCIDENTAL falls; HOSPITAL care; DESCRIPTIVE statistics; ADVERSE health care events; LONGITUDINAL method; BONE fractures; DISEASE risk factors
- Publication
Journal of Nutrition, Health & Aging, 2022, Vol 26, Issue 12, p1054
- ISSN
1279-7707
- Publication type
Article
- DOI
10.1007/s12603-022-1859-8