Johns Hopkins scientists report that a 10-minute test for "frailty" first designed to predict whether the elderly can withstand surgery and other physical stress could be useful in assessing the increased risk of death and frequent hospitalization among kidney dialysis patients of any age.
In a study described in the Journal of the American Geriatrics Society and published online yesterday, the Johns Hopkins investigators said dialysis patients deemed frail by the simple assessment were more than twice as likely to die within three years, and much more likely to be hospitalized repeatedly.
Results of the frailty test, which measures physiological reserve, suggest that kidney failure patients who submit to the long and arduous process of mechanical blood cleansing several days a week are undergoing a premature aging process detrimental to their health, the researchers say.
"More than 600,000 people are on dialysis and they have a wide range of mortality and hospitalization risks," says study leader Dorry L. Segev, M.D., Ph.D., an associate professor of surgery at the Johns Hopkins University School of Medicine. "But we're not very good at predicting who is at more or less risk for hospitalization and death. This assessment tool gives us much better insights into which dialysis patients are at greater risk, so that their treatment can be tailored to minimize complications, hospitalizations or death."
Dialysis machines do much of the work of damaged kidneys, cleansing the blood of waste and excess water. Dialysis cannot, however, fully compensate for the blood pressure and fluid control roles played by kidneys, and the body can weaken as it tries to make up for what is missing, Segev says. The only cure for kidney failure is a kidney transplant.
In the study, frailty was measured using a five-point scale developed at Johns Hopkins. Patients are classified as frail if they meet three or more of the following crit
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Johns Hopkins Medicine