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首页> 外文期刊>Clinical kidney journal. >Frailty and chronic kidney disease: current evidence and continuing uncertainties
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Frailty and chronic kidney disease: current evidence and continuing uncertainties

机译：体弱和慢性肾脏疾病：当前证据和持续的不确定性

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Frailty, the state of increased vulnerability to physical stressors as a result of progressive and sustained degeneration in multiple physiological systems, is common in those with chronic kidney disease (CKD). In fact, the prevalence of frailty in the older adult population is reported to be 11%, whereas the prevalence of frailty has been reported to be greater than 60% in dialysis-dependent CKD patients. Frailty is independently linked with adverse clinical outcomes in all stages of CKD and has been repeatedly shown to be associated with an increased risk of mortality and hospitalization. In recent years there have been efforts to create an operationalized definition of frailty to aid its diagnosis and to categorize its severity. Two principal concepts are described, namely the Fried Phenotype Model of Physical Frailty and the Cumulative Deficit Model of Frailty. There is no agreement on which frailty assessment approach is superior, therefore, for the time being, emphasis should be placed on any efforts to identify frailty. Recognizing frailty should prompt a holistic assessment of the patient to address risk factors that may exacerbate its progression and to ensure that the patient has appropriate psychological and social support. Adequate nutritional intake is essential and individualized exercise programmes should be offered. The acknowledgement of frailty should prompt discussions that explore the future care wishes of these vulnerable patients. With further study, nephrologists may be able to use frailty assessments to inform discussions with patients about the initiation of renal replacement therapy.
机译：脆弱，由于多种生理系统的持续不断的退化而增加了对身体压力的脆弱性，这种状态在患有慢性肾脏病（CKD）的患者中很常见。实际上，据报道，老年人口的脆弱性患病率为11％，而据报道，依赖透析的CKD患者的脆弱性患病率大于60％。在CKD的所有阶段，虚弱都与不良的临床结局独立相关，并且反复被证明与死亡率和住院风险的增加有关。近年来，人们一直在努力建立一个脆弱的可操作定义，以帮助其诊断和对严重程度进行分类。描述了两个主要概念，即身体脆弱的表型模型和脆弱性的累积赤字模型。对于哪种脆弱性评估方法是优胜劣汰，目前尚无共识，因此，目前应着重于识别脆弱性的任何努力。认识到身体虚弱应促使对患者进行全面评估，以解决可能加剧其进展的危险因素，并确保患者获得适当的心理和社会支持。充足的营养摄入至关重要，应提供个性化的锻炼计划。对身体虚弱的认识应促使人们进行讨论，以探索这些弱势患者未来的护理愿望。通过进一步的研究，肾病医师可能能够使用脆弱性评估来告知与患者有关开始肾脏替代治疗的讨论。

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