Frailty Syndrome in Non-geriatric Dialysis Patients in Georgia: Prevalence and Clinical Correlates in a Cross-Sectional Study

Abstract

Background Frailty is a multidimensional syndrome strongly associated with poor quality of life, hospitalization, and mortality in patients with chronic kidney disease (CKD). While frailty in dialysis populations has been well characterized in geriatric patients, its prevalence and correlates among non-geriatric adults remain poorly understood. Methods This cross-sectional study enrolled 50 non-geriatric patients (aged 18-64 years) with CKD stage 5D (dialysis-dependent) receiving maintenance hemodialysis at a single center in Tbilisi, Georgia. Frailty was assessed using the FRAIL (Fatigue, Resistance, Ambulation, Illness, and Loss of weight) scale, classifying participants as robust, prefrail, or frail. Demographic data, body mass index (BMI), smoking status, comorbidities, and biochemical correlates were evaluated using Fisher's exact test and multinomial logistic regression. Results The mean age was 54.34 ± 8.26 years, and 33 (66%) participants were male. Prefrailty was the most common classification, affecting 22 (44%) participants, followed by robust status in 18 (36%) and frailty in 10 (20%). In multinomial regression, smoking history (pack-years) was inversely associated with frailty in both the frail-vs-robust (p = 0.021) and prefrail-vs-frail (p = 0.005) comparisons. Phosphate levels were significantly associated with frailty in the prefrail-vs-frail comparison (p = 0.04) and showed a non-significant trend in the frail-vs-robust comparison (p = 0.092). Dialysis duration was significantly associated with frailty in the prefrail-vs-frail comparison only (p = 0.016). A non-linear relationship between BMI and frailty was observed, with the highest frailty prevalence among participants with class I obesity, affecting four (57.14%) participants of that subgroup. Comorbidities showed no statistically significant associations with frailty status. Conclusion Frailty and prefrailty are common among non-geriatric patients with CKD stage 5D, indicating that frailty in this population is not solely age-driven. Phosphate levels and dialysis duration emerged as clinically relevant correlates, supporting the incorporation of routine frailty screening in non-geriatric dialysis care. Larger longitudinal multi-center studies are needed to confirm these findings and clarify their prognostic significance.