Characteristics And Risk Factors Of Frailty And Sleep Disorders In Maintenance Hemodialysis Patients In Rural China

Objective: To investigate the incidence and risk factors of asthenia and sleep disorders in maintenance hemodialysis patients in rural China.Methods: The patients who received maintenance hemodialysis in the Blood Purification Center of People’s Hospital of Macheng City from October 2020 to November2021 were selected.FRAIL levels can be evaluated by The Frail Screening Scale(The FRAIL Scale)and sleep status by the Pittsburgh Sleep Quality Index Scale(PSQI).At the same time,clinical baseline data of patients were collected.Multivariate logistic regression was thenused to analyze the influencing factors of frailty and sleep disorders.Results: A total of 303 patients were enrolled in this study,including 79 patients(26%)in the frailty group,109 patients(36%)in the pre-frailty group,and 115 patients(38%)in the stable group.237 people(78.2%)in sleep disorder group and 66 people(21.8%)in non-sleep disorder group;The proportion of sleep disorders increased with the severity of frailty(66.96% v.s.81.65% v.s.89.97%,P < 0.001);The incidence of frailty was significantly higher in patients with sleep disorders than in those without sleep disorders(12.12% v.s.29.96%,P < 0.001).Multivariate logistic regression found that Patients with anxiety had a4.463 times higher risk of frailty than those without anxiety(OR=4.463,95% CI:2.061-9.664,P<0.01),The risk of frailty was 2.032 times higher in patients with depression than in patients without depression(OR=2.032,95% CI: 1.063-3.882,P<0.05).The risk of sleep disorders was 2.107 times higher in female than in male(OR=2.107,95% CI:1.027-4.321,P<0.05),and 2.921 times higher in patients with hypertension(OR=2.921,95% CI:1.161-7.353,P<0.05);Unemployed patients had 82.9% lower risk of sleep disorders than civil servants OR retired workers(OR=0.171,95% CI:0.052-0.566,P<0.01).Compared with civil servants and retired workers,the risk of sleep disorders of self-employed people was decreased by 87.4%(OR=0.126,95% CI:0.024-0.658,P<0.01).Compared with those with years of schooling ≤12y,patients with years of schooling > 12 y had a 66.4 percent lower risk of developing sleep disorders(OR=0.336,95% CI:0.159-0.707,P<0.01);Patients with anxiety were 5.926 times more likely to develop sleep disorders(OR=5.926,95% CI:1.385-25.35,P<0.05).Increased BMI was associated with a 1.101-fold increased risk of frilty and sleep disorders(OR=1.101,95%CI:1.005-1.208,P < 0.05).Compared with those with years of schooling ≤12y,patients with years of schooling > 12 y had 65.3% lower risk of combined frailty and sleep disorders(OR=0.347,95%CI: 0.136-0.886,P < 0.05).Patients with anxiety OR depression had a 5.998fold(OR=5.998,95%CI: 2.627-13.698,P < 0.01)and a 2.225-fold(OR=2.225,95%CI:1.089-4.548,P < 0.05)increased risk of combined frailty and sleep disorders,respectively.Conclusions: Frailty and sleep disorders are common in MHD patients,and the higher the BMI,the shorter the age of education,and the patients with anxiety or depression,the higher the risk of combined with frailty and sleep disorders.