Association between body composition and frailty among prevalent hemodialysis patients: A US renal data system special study

Kirsten L. Johansen, Lorien Dalrymple, Cynthia Delgado, George Kaysen, John Kornak, Barbara Grimes, Glenn M. Chertow

Research output: Contribution to journalArticle

73 Citations (Scopus)

Abstract

Studies of frailty among patients on hemodialysis have relied on definitions that substitute self-reported functioning for measures of physical performance and omit weight loss or substitute alternate criteria. We examined the association between body composition and a definition of frailty that includes measured physical performance and weight loss in a cross-sectional analysis of 638 adult patients receiving maintenance hemodialysis at 14 centers. Frailty was defined as having three of following characteristics: weight loss, weakness, exhaustion, low physical activity, and slow gait speed. We performed logistic regression with body mass index (BMI) and bioelectrical impedance spectroscopy (BIS)-derived estimates of intracellular water (ICW), fat mass, and extracellular water (ECW) as the main predictors, and age, sex, race, and comorbidity as covariates. Overall, 30% of participants were frail. Older age (odds ratio [OR], 1.31 per 10 years; 95%confidence interval [95% CI],1.14 to 1.50), diabetes (OR, 1.65; 95% CI, 1.13 to 2.40), higherfat mass (OR, 1.18; 95% CI, 1.02to 1.37), and higher ECW (OR, 1.33; 95% CI, 1.20 to 1.47) associated with higher odds of frailty. Higher ICW associated with lower odds of frailty (OR, 0.80 per kg; 95% CI, 0.73 to 0.87). The addition of BMI data did not change the area under the receiver operating characteristics curve (AUC; AUC=0.66 versus 0.66; P=0.71), but the addition of BIS data did change the AUC (AUC=0.72; P<0.001). Thus, individual components of body composition but not BMI associate strongly with frailty in this cohort of patients receiving hemodialysis.

Original languageEnglish (US)
Pages (from-to)381-389
Number of pages9
JournalJournal of the American Society of Nephrology
Volume25
Issue number2
DOIs
StatePublished - Feb 2014

Fingerprint

Body Composition
Information Systems
Renal Dialysis
Odds Ratio
Area Under Curve
Confidence Intervals
Kidney
Dielectric Spectroscopy
Weight Loss
Body Mass Index
Water
Electric Impedance
ROC Curve
Comorbidity
Cross-Sectional Studies
Logistic Models
Fats
Maintenance
Exercise

ASJC Scopus subject areas

  • Nephrology

Cite this

Association between body composition and frailty among prevalent hemodialysis patients : A US renal data system special study. / Johansen, Kirsten L.; Dalrymple, Lorien; Delgado, Cynthia; Kaysen, George; Kornak, John; Grimes, Barbara; Chertow, Glenn M.

In: Journal of the American Society of Nephrology, Vol. 25, No. 2, 02.2014, p. 381-389.

Research output: Contribution to journalArticle

Johansen, Kirsten L. ; Dalrymple, Lorien ; Delgado, Cynthia ; Kaysen, George ; Kornak, John ; Grimes, Barbara ; Chertow, Glenn M. / Association between body composition and frailty among prevalent hemodialysis patients : A US renal data system special study. In: Journal of the American Society of Nephrology. 2014 ; Vol. 25, No. 2. pp. 381-389.
@article{135ec71f0e7b449fab83c051b60fe4fb,
title = "Association between body composition and frailty among prevalent hemodialysis patients: A US renal data system special study",
abstract = "Studies of frailty among patients on hemodialysis have relied on definitions that substitute self-reported functioning for measures of physical performance and omit weight loss or substitute alternate criteria. We examined the association between body composition and a definition of frailty that includes measured physical performance and weight loss in a cross-sectional analysis of 638 adult patients receiving maintenance hemodialysis at 14 centers. Frailty was defined as having three of following characteristics: weight loss, weakness, exhaustion, low physical activity, and slow gait speed. We performed logistic regression with body mass index (BMI) and bioelectrical impedance spectroscopy (BIS)-derived estimates of intracellular water (ICW), fat mass, and extracellular water (ECW) as the main predictors, and age, sex, race, and comorbidity as covariates. Overall, 30{\%} of participants were frail. Older age (odds ratio [OR], 1.31 per 10 years; 95{\%}confidence interval [95{\%} CI],1.14 to 1.50), diabetes (OR, 1.65; 95{\%} CI, 1.13 to 2.40), higherfat mass (OR, 1.18; 95{\%} CI, 1.02to 1.37), and higher ECW (OR, 1.33; 95{\%} CI, 1.20 to 1.47) associated with higher odds of frailty. Higher ICW associated with lower odds of frailty (OR, 0.80 per kg; 95{\%} CI, 0.73 to 0.87). The addition of BMI data did not change the area under the receiver operating characteristics curve (AUC; AUC=0.66 versus 0.66; P=0.71), but the addition of BIS data did change the AUC (AUC=0.72; P<0.001). Thus, individual components of body composition but not BMI associate strongly with frailty in this cohort of patients receiving hemodialysis.",
author = "Johansen, {Kirsten L.} and Lorien Dalrymple and Cynthia Delgado and George Kaysen and John Kornak and Barbara Grimes and Chertow, {Glenn M.}",
year = "2014",
month = "2",
doi = "10.1681/ASN.2013040431",
language = "English (US)",
volume = "25",
pages = "381--389",
journal = "Journal of the American Society of Nephrology : JASN",
issn = "1046-6673",
publisher = "American Society of Nephrology",
number = "2",

}

TY - JOUR

T1 - Association between body composition and frailty among prevalent hemodialysis patients

T2 - A US renal data system special study

AU - Johansen, Kirsten L.

AU - Dalrymple, Lorien

AU - Delgado, Cynthia

AU - Kaysen, George

AU - Kornak, John

AU - Grimes, Barbara

AU - Chertow, Glenn M.

PY - 2014/2

Y1 - 2014/2

N2 - Studies of frailty among patients on hemodialysis have relied on definitions that substitute self-reported functioning for measures of physical performance and omit weight loss or substitute alternate criteria. We examined the association between body composition and a definition of frailty that includes measured physical performance and weight loss in a cross-sectional analysis of 638 adult patients receiving maintenance hemodialysis at 14 centers. Frailty was defined as having three of following characteristics: weight loss, weakness, exhaustion, low physical activity, and slow gait speed. We performed logistic regression with body mass index (BMI) and bioelectrical impedance spectroscopy (BIS)-derived estimates of intracellular water (ICW), fat mass, and extracellular water (ECW) as the main predictors, and age, sex, race, and comorbidity as covariates. Overall, 30% of participants were frail. Older age (odds ratio [OR], 1.31 per 10 years; 95%confidence interval [95% CI],1.14 to 1.50), diabetes (OR, 1.65; 95% CI, 1.13 to 2.40), higherfat mass (OR, 1.18; 95% CI, 1.02to 1.37), and higher ECW (OR, 1.33; 95% CI, 1.20 to 1.47) associated with higher odds of frailty. Higher ICW associated with lower odds of frailty (OR, 0.80 per kg; 95% CI, 0.73 to 0.87). The addition of BMI data did not change the area under the receiver operating characteristics curve (AUC; AUC=0.66 versus 0.66; P=0.71), but the addition of BIS data did change the AUC (AUC=0.72; P<0.001). Thus, individual components of body composition but not BMI associate strongly with frailty in this cohort of patients receiving hemodialysis.

AB - Studies of frailty among patients on hemodialysis have relied on definitions that substitute self-reported functioning for measures of physical performance and omit weight loss or substitute alternate criteria. We examined the association between body composition and a definition of frailty that includes measured physical performance and weight loss in a cross-sectional analysis of 638 adult patients receiving maintenance hemodialysis at 14 centers. Frailty was defined as having three of following characteristics: weight loss, weakness, exhaustion, low physical activity, and slow gait speed. We performed logistic regression with body mass index (BMI) and bioelectrical impedance spectroscopy (BIS)-derived estimates of intracellular water (ICW), fat mass, and extracellular water (ECW) as the main predictors, and age, sex, race, and comorbidity as covariates. Overall, 30% of participants were frail. Older age (odds ratio [OR], 1.31 per 10 years; 95%confidence interval [95% CI],1.14 to 1.50), diabetes (OR, 1.65; 95% CI, 1.13 to 2.40), higherfat mass (OR, 1.18; 95% CI, 1.02to 1.37), and higher ECW (OR, 1.33; 95% CI, 1.20 to 1.47) associated with higher odds of frailty. Higher ICW associated with lower odds of frailty (OR, 0.80 per kg; 95% CI, 0.73 to 0.87). The addition of BMI data did not change the area under the receiver operating characteristics curve (AUC; AUC=0.66 versus 0.66; P=0.71), but the addition of BIS data did change the AUC (AUC=0.72; P<0.001). Thus, individual components of body composition but not BMI associate strongly with frailty in this cohort of patients receiving hemodialysis.

UR - http://www.scopus.com/inward/record.url?scp=84893467717&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=84893467717&partnerID=8YFLogxK

U2 - 10.1681/ASN.2013040431

DO - 10.1681/ASN.2013040431

M3 - Article

C2 - 24158987

AN - SCOPUS:84893467717

VL - 25

SP - 381

EP - 389

JO - Journal of the American Society of Nephrology : JASN

JF - Journal of the American Society of Nephrology : JASN

SN - 1046-6673

IS - 2

ER -