الفهرس 
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Abstract
Frailty can be defined as a clinical syndrome in which there is a state of dysregulation of energetics and multiple physiological systems when reaching a critical threshold, increase in an individual’s vulnerability to developing negative health-related events (including disability, hospitalizations, institutionalizations, and death)
It can be due to accumulation of a number of unrelated diseases, impairments, and other health conditions in an individual or due to Age-associated declines in physiologic reserve and function across multi organ systems, leading to increased vulnerability for adverse health outcomes.
Frailty is common in those with chronic kidney disease (CKD). The prevalence of frailty in the community-dwelling older adult population is reported to be 11%, whereas studies have reported a frailty prevalence of > 60% in dialysis-dependent CKD patients
The aim is to determine the prevalence of frailty in patient with CKD and Hemodialysis patients and to study the effect of kidney diseases on the occurrence of frailty in elderly.
We conducted a cross-sectional study to estimate the prevalence of frailty among elderly in patients with kidney disease.
The study included 100 elderly patients Males and Females aging 60 years or more recruited from inpatient ward and outpatient clinics in Ain Shams University hospital, 50 patients on regular hemodialysis and 50 patients diagnosed with chronic renal impairment.
All individuals were subjected to comprehensive geriatric assessment including; cognitive function assessment by using mini-mental status examination, Screening for depression using GDS-15, Functional assessment using ADL and IADL, and Assessment for fall risk by using Timed up and go test, one leg balance test.
Assessment of frailty by using a modified version of Fried criteria that included: unintentional weight loss, self-reported exhaustion, low physical activity, slow walking speed and weak grip strength using a manual hydraulic dynamometer type JAMAR.
Assessment of fatigue by multidimensional assessment of fatigue (MAF).
chronic kidney disease will be classified according to the KDIQO guidelines 2012 which classifies the stages of chronic kidney disease by
Cockcroft gault equation for estimation of glomerular filtration for weight and age.
Also serum creatinine, calcium, sodium, potassium, Phosphorous, hemoglobuline were measugred.
The prevalence of frailty was 79% of patients with kidney diseases; it was 66% in CKD patients and 94% in hemodialysis patients.
Regarding demographic data age and marital status had statistically significance difference between both frail CKD and hemodialysis.
Regarding past history DM, HTN, cardiac diseases, osteoporosis and history of fall has statically difference between both frail CKD and hemodialysis and with frail score. Also MMSE and GDS showed significant correlation with frail score.
There were functional decline in ADL and IADL and mean of frailty.
TUGO and one leg balance test had statistically significance with mean frailty score, but one leg balance test was significance between frail CKD and hemodialysis.
BMI had statistically difference with mean of frailty score, over weight had the least mean frailty score, under-weight had the highest mean frailty score.
GFR had statistically significance with frailty score which was more prominent in hemodialysis frail group. Also MAF had statistically significance with frail score in hemodialysis group.