Abstract:
Frailty is a condition that is frequently observed among patients undergoing dialysis. Frailty is characterized by a decline in both physiological state and cognitive state, leading to a combination of symptoms, such as weight loss, exhaustion, low physical activity level, weakness, and slow walking speed. Frail patients not only experience a poor quality of life, but also are at higher risk of hospitalization, infection, cardiovascular events, dialysis-associated complications, and death. Frailty occurs as a result of a combination and interaction of various medical issues in patients who are on dialysis. Unfortunately, frailty has no cure. To address frailty, a multifaceted approach is necessary, involving coordinated efforts from nephrologists, geriatricians, nurses, allied health practitioners, and family members. Strategies such as optimizing nutrition and chronic kidney disease-related complications, reducing polypharmacy by deprescription, personalizing dialysis prescription, and considering home-based or assisted dialysis may help slow the decline of physical function over time in subjects with frailty. This review discusses the underlying causes of frailty in patients on dialysis and examines the methods and difficulties involved in managing frailty among this group.
摘要:
虚弱是在进行透析的患者中经常观察到的病症。它的特点是生理和认知状态都下降,导致体重减轻等症状的组合,疲惫,低体力活动,弱点,缓慢的行走速度。虚弱的患者不仅生活质量差,但是他们住院的风险也更高,感染,心血管事件,透析相关并发症,和死亡。虚弱是由于透析患者中各种医学问题的组合和相互作用而发生的。不幸的是,没有治愈脆弱的方法。为了解决脆弱,多方面的方法是必要的,涉及肾病学家的协调努力,老年病学家,护士,专职医疗人员,和家庭成员。优化营养和CKD相关并发症等策略,通过处方减少多重用药,个性化透析处方和考虑家庭透析或辅助透析可能有助于减缓虚弱患者身体功能随时间的下降.这篇综述讨论了透析患者虚弱的根本原因,并研究了该组中管理虚弱的方法和困难。