Construction and validation of a nomogram model for predicting frailty risk in uremia patients undergoing maintenance hemodialysis
Objective To explore the influencing factors of frailty risk in uremia patients un-dergoing maintenance hemodialysis and to construct a predictive nomogram model.Methods A total of 210 patients who underwent maintenance hemodialysis in the Department of Nephrolo-gy of Ma'anshan People's Hospital from May 2021 to September 2023 were selected as the study subjects.They were divided into frailty group(with frailty symptoms,n=54)and non-frailty group(without frailty symptoms,n=156).Univariate analysis was performed on the clinical data of the two groups,and statistically significant factors were subjected to regression analysis.A nomogram was plotted to determine the influencing factors of frailty risk in uremia patients undergoing maintenance hemodialysis.Results There was no statistical difference be-tween the two groups in terms of gender,body mass index(BMI),education level,smoking history,history of diabetes,history of hypertension,economic status,hospital anxiety and de-pression scale(HADS),blood urea nitrogen(BUN),creatinine(Cr),cystatin C(CysC),po-tassium(K),calcium(Ca),phosphorus(P),parathyroid hormone(PTH),blood β2-MG(be-ta-2 microglobulin),serum ferritin(SF),and folic acid(FA)(P>0.05).The frailty group showed statistically significant differences compared with the non-frailty group in age,duration of dialysis,physical activity status,short physical performance battery(SPPB),albumin(Alb),and hemoglobin(Hb)(P<0.05).Multivariate regression analysis indicated that age≥60 years,prolonged dialysis duration,and never/occasionally exercising were independent risk factors for the occurrence of frailty in patients with end-stage renal disease undergoing ma-intenance hemodialysis(P<0.05).A high SPPB score and high levels of Alb were protective factors against the onset of frailty in these patients(P<0.05).A nomogram was constructed,which demonstrated good predictive value.Conclusion Age≥60 years,prolonged dialysis,and infrequent/no exercise increase the risk of frailty in uremia patients undergoing mainte-nance hemodialysis.