Association between frailty, frailty domains, and health-related hope in patients with pre-dialysis chronic kidney disease

Health-related hope is an essential psychological resource for patients managing chronic diseases, especially in cases of chronic kidney disease (CKD), but factors influencing it remain unclear. 

An Osaka Metropolitan University-led research team examined the relationship between frailty and health-related hope and identified specific frailty domains affecting health-related hope in patients with pre-dialysis CKD. The team’s cross-sectional study included patients with pre-dialysis CKD aged ≥ 50 years, without dialysis or kidney transplantation history. Frailty and specific frailty domains were measured using the Kihon Checklist, while health-related hope was assessed with a validated scale. Health-related hope scores were compared across robust, pre-frailty, and frailty groups using one-way ANOVA. Multivariate regression analysis was used to examine associations while adjusting for confounders.

Among 285 patients in the analysis, the mean age was 67.9 years, 249 (87.4%) were male, and the mean estimated glomerular filtration rate was 40.7 mL/min/1.73m². Mean health-related hope scores were 63.1 in the robust group, 54.5 in the pre-frailty group, and 41.4 in the frailty group, indicating lower levels of health-related hope among patients with greater frailty. In the adjusted model of multivariate regression, pre-frailty and frailty were significantly associated with lower health-related hope. Additionally, depressive symptoms, reduced oral, cognitive, and physical function, and being homebound were also linked to lower health-related hope.

Frailty and specific frailty domains were associated with lower health-related hope in patients with pre-dialysis CKD. These findings underscore the importance of comprehensive frailty assessment and interventions addressing physical, psychological, and social factors.

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