Frailty at Dialysis Initiation Linked to Higher eGFR

Frailty is quite common among patients starting dialysis in the United States, and it is associated with a higher estimated glomerular filtration rate (eGFR) at dialysis initiation, researchers reported.

Yeran Bao, MD, of the University of California-San Francisco, and colleagues studied 1,576 participants in the Comprehensive Dialysis Study (CDS), a special study of the U.S. Renal Data System. The researchers identified frailty in 73% of subjects. A higher eGFR at dialysis initiation was associated with a 44% increased odds of frailty, according to findings published in Archives of Internal Medicine (2012;172:1071-1077). In addition, frailty was independently associated with a 57% increased odds of death. Higher eGFR at dialysis initiation was significantly associated with increased mortality, but the association became non-significant after accounting for frailty, the researchers said.

“Recognition of signs and symptoms of frailty by clinicians may prompt earlier initiation of dialysis and may explain, at least in part, the well-described association between eGFR at dialysis initiation and mortality,” the authors concluded.

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