WASHINGTON—Frailty may prolong recovery from a dialysis session, researchers reported at the American Society of Nephrology’s Kidney Week 2019 meeting.

“Recovery time has been associated with downstream outcomes, including worse quality of life and mortality,” investigator Jessica Fitzpatrick, MD, PhD, of The Hospital for Sick Children in Toronto, told Renal & Urology News. “Our results suggest that frail, and particularly younger frail, individuals should be targeted for interventions, such as strength training, to improve hemodialysis recovery times.”

Using the Predictors of Arrhythmic and Cardiovascular Risk in End Stage Renal Disease (PACE) study sample, investigators stratified 385 new hemodialysis (HD) patients from 27 dialysis units in Baltimore (mean age 55 years; 43% female; 73% black) by Fried frailty phenotype: Non-frail, intermediately frail, and frail patients reported 0 to 1, 2, and 3 or more, respectively, of the 5 physical criteria (unintentional weight loss, exhaustion, slowed gait speed, weakness, or low physical activity). Patients self-reported their post-dialysis recovery time by answering the question, “How long does it take you to recover from a dialysis session?” Two-thirds of all patients reported recovery times of less than 1 hour. Median recovery time was 20 minutes. Only 5% reported recovery times longer than 12 hours.

Compared with non-frail patients, intermediately frail and frail patients had 2.6- and 1.7-fold longer recovery times, respectively, Dr Fitzpatrick and her collaborators reported. Patients with cerebrovascular disease or obesity also had roughly double the risk for prolonged recovery.

The team also observed an independent age effect among frail patients. Frail patients aged 65 years or less were more than twice as likely as older patients to report longer recovery times.

“Future studies should assess the impact of frailty-targeted interventions on recovery time to improve clinical outcomes,” Dr Fitzpatrick said.

Reference

Fitzpatrick J, Sozio SM, Jaar B, et al. Frailty, age, and post-dialysis recovery time in an incident hemodialysis population. Presented at the American Society of Nephrology’s Kidney Week 2019 meeting held November 5-10, 2019 in Washington DC. Abstract TH-PO250.