Frailty and Quality of Life in Hemodialysis Patients: An Edmonton Frail Scale-Based Assessment in a South Asian Cohort

Introduction: Frailty is a complex health condition that can adversely affect both the physical and mental health of patients who are on maintenance hemodialysis. Assessing frailty in this population could help identify patients at risk of adverse outcomes early. Objective: This study aimed to determine frailty condition through the Edmonton Frail Scale (EFS) and investigate its relationship with kidney disease-related quality of life in South Asian patients receiving hemodialysis. Methods: A total of 448 adults who had undergone maintenance hemodialysis for at least three months were included in the current cross-sectional study. Frailty was assessed using the EFS, and quality of life was measured using the Kidney Disease Quality of Life-36 (KDQOL-36) questionnaire. The Spearman's rank correlation, the Mann-Whitney U test, the Kruskal-Wallis H test, and multiple linear regression were among the various statistical approaches utilized for data analysis. Results: Frailty showed a strong inverse relationship with quality of life (ρ = -0.317, p < 0.001). Women had a higher frailty score than men but a lower KDQOL score (p < 0.001). The frailty score was positively correlated with age, while quality of life was negatively correlated with age (p < 0.001). According to regression analysis, greater frailty (B = -0.812), older age, female sex, longer duration of dialysis, more frequent dialysis, and higher comorbidity were significant factors associated with lower quality of life (p ≤ 0.01). Conclusion: Frailty was significantly associated with reduced quality of life among patients on hemodialysis, highlighting the importance of routine frailty screening during hemodialysis care.