Prolonged end-stage kidney disease (ESKD) is a risk factor for frailty and the number of patients in Japan receiving maintenance dialysis for more than 20 years is large and growing. This study aimed to characterize the association of dialysis vintage and frailty among patients receiving dialysis in Japan. Cross-sectional study. Patients with ESKD aged over 50 years of age who received maintenance dialysis in 2018 as represented in the JSDT Renal Data Registry database (n=227,136). Dialysis vintage categorized as: 0–<5 years, 5–<10 years, 10–<20 years, 20–<30 years, and over 30 years. The frailty and bedridden status were defined as graded ≥2 and graded 4, respectively, according to the Eastern Cooperative Oncology Group Performance Status scale. Poisson regression models with robust error variance adjusted for potential covariates were used to estimate the adjusted prevalence ratios (aPRs) for frailty and bedridden status. Clinical characteristics of patients undergoing dialysis for ≥ 30 years were also described. Among the study cohort, 5510 patients (2.4%) had been undergoing dialysis for 30 years or more. The prevalence of frailty in the group with over 30 years of dialysis history was 36.2%, while the rate of being bedridden was 6.4%. Compared to <5 years, dialysis vintages of 5–<10 years, 10–<20 years, 20–<30 years, and over 30 years were associated with frailty (aPRs [95% confidence intervals]: 1.06 [1.05-1.08], 1.10 [1.08-1.11], 1.14 [1.10-1.17], and 1.67 [1.60-1.73]), respectively. Compared to <5 years, dialysis vintages of 5–<10 years, 10–<20 years, 20–<30 years, and over 30 years were associated with being bedridden (aPRs [95% confidence intervals]: 1.17 [1.13-1.22], 1.26 [1.20-1.31], 1.17 [1.08-1.26], and 1.66 [1.49-1.86], respectively. Patients receiving short-term dialysis may have more unmeasured comorbidities compared to patients receiving long-term dialysis. Long-term dialysis therapy, particularly exceeding 30 years, is associated with deterioration of physical function and frailty.

中文翻译：

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虚弱和维持透析的持续时间：日本全国横断面研究


长期的终末期肾病 (ESKD) 是导致虚弱的危险因素，在日本接受维持性透析超过 20 年的患者数量庞大且不断增长。本研究旨在探讨日本接受透析的患者的透析时间与虚弱之间的关系。横断面研究。 JSDT 肾脏数据登记数据库中显示，2018 年接受维持性透析的年龄超过 50 岁的 ESKD 患者（n=227,136）。透析年份分类为：0–<5年、5–<10年、10–<20年、20–<30年和30年以上。根据东部肿瘤合作组表现状态量表，虚弱和卧床状态分别定义为≥2级和4级。使用针对潜在协变量调整的稳健误差方差的泊松回归模型来估计虚弱和卧床状态的调整患病率（aPR）。还描述了接受透析≥30年的患者的临床特征。在研究队列中，5510 名患者 (2.4%) 已经接受透析 30 年或更长时间。透析史超过30年的人群衰弱率为36.2%，卧床率为6.4%。与 <5 年相比，5-<10 年、10-<20 年、20-<30 年和超过 30 年的透析年份与虚弱相关（aPR [95% 置信区间]：1.06 [1.05-1.08] 、1.10 [1.08-1.11]、1.14 [1.10-1.17] 和 1.67 [1.60-1.73]）。与<5年相比，5-<10年、10-<20年、20-<30年和超过30年的透析年份与卧床不起有关（aPR [95%置信区间]：1.17 [1.13-1.22 ]、1.26 [1.20-1.31]、1.17 [1.08-1.26] 和 1.66 [1.49-1.86]。 与接受长期透析的患者相比，接受短期透析的患者可能有更多未测量的合并症。长期透析治疗，特别是超过30年，会导致身体机能恶化和虚弱。