#3882 THE PREVALENCE AND EVOLUTIONARY EFFECTS OF FRAILTY IN PERITONEAL DIALYSIS PATIENTS

Abstract Background and Aims Frailty is an age-related condition that predicts adverse outcomes. The clinical effect of frailty in peritoneal dialysis (PD) patients is unmet. The study was aimed to investigate the clinical implications of frailty in PD patients. Method In this prospective study, PD patients completed frailty assessment at entry and 6 months by a semiautomated frailty index of 80 risk factors (FI80) which also contained the 5 components of Fried frailty phenotype. A score ≥13/80 (FI80 ≥0.16) or ≥3/5 (frailty phenotype) was designated to define frailty. Results A total of 337 PD patients were recruited (new-onset 23.4%, prevalent 76.6%). Two hundred (59.3%) and 163 (48.4%) patients were frail by FI80 and frailty phenotype, respectively. Predictors for frailty were old age, dialysis, diabetes mellitus, gout and sleep disorder. New-onset patients aged <55 years displayed the best evolution of frailty over 6 months (stable or improved, n = 29/47, 61.7% by FI80, p = 0.0293), compared with other groups. Survival analysis found that frail patients exhibited the worse outcomes (overall death and hospitalization) than their robust and prefrail counterparts. Poisson regression showed frailty was associated with increased utilizations of outpatient and ER visit; however multivariate Cox models identified only diabetes, gout history and low body mass index (<19kg/m2), but not frailty, predicted overall death and hospitalizations. Conclusion Our data indicate that frailty is a common medical condition in PD patients, and the status of which can be stabilized or improved in new-onset, young patients at least over the short term. Compared with frailty, certain comorbidities (diabetes and gout history) and undernutrition appeared to be more robust in the prediction of adverse outcomes.