Frailty is described by Fried et al. [1] as a clinical syndrome involving at least three of the following features: unintentional weight loss (10 lbs in one year), self-reported exhaustion, weakness (as determined by grip strength), slow walking speed, and low physical activity. It is highly prevalent among patients on dialysis, with a prevalence of up to 67.7% in previous report [2].
Physical frailty has important health consequences. Frail patients are more susceptible to the development of adverse outcomes when faced with a stressor. It also leads to a decline in physical function, gait disability, increase in the risks of fall. As a result, frail peritoneal dialysis (PD) patients have a higher hospitalization risk and their hospital stay tends to be prolonged [3]. Physical frailty is also a well-established independent predictor of adverse outcomes including mortality in pre-dialysis end stage renal disease patients [4], hemodialysis (HD) patients and PD patients [3, 5].
Physical frailty causes alteration in body composition. Frail patients tend to suffer from obesity [6–9]. On the other hand, PD patients are more susceptible to central obesity [10] due to exposure to glucose-containing dialysate fluid. In contrast to general obesity, central obesity confers a worse survival in dialysis patients [11]. Previous study has shown synergistic effect on mortality between physical frailty and central obesity in HD patients. However, the interaction between physical frailty and body composition has not been explored.
