Hui Zhang1,2,3, Meng Hao1, Yi Li1, Xiaoyan Jiang4, Mengjing Wang3,5, Jing Chen3,5, Xiaofeng Wang1,2,3, Xuehui Sun6,7,8. 1. Human Phenome Institute and National Clinical Research Center for Aging and Medicine, Huashan Hospital, Fudan University, Shanghai, China. 2. Fudan University-the People's Hospital of Rugao Joint Research Institute of Longevity and Aging, Rugao, Jiangsu, China. 3. National Clinical Research Center for Aging and Medicine, Huashan Hospital, Fudan University, Shanghai, China. 4. Key Laboratory of Arrhythmias, Ministry of Education, Department of Pathology and Pathophysiology, School of Medicine, Tongji University, Shanghai, China. 5. Department of Nephrology, Huashan Hospital, Fudan University, Shanghai, China. 6. Human Phenome Institute and National Clinical Research Center for Aging and Medicine, Huashan Hospital, Fudan University, Shanghai, China. xhsun@fudan.edu.cn. 7. Fudan University-the People's Hospital of Rugao Joint Research Institute of Longevity and Aging, Rugao, Jiangsu, China. xhsun@fudan.edu.cn. 8. National Clinical Research Center for Aging and Medicine, Huashan Hospital, Fudan University, Shanghai, China. xhsun@fudan.edu.cn.
Abstract
BACKGROUND AND AIM: A decreased estimated glomerular filtration rate (eGFR) is associated with frailty, but the association between kidney function and frailty using multidimensional assessments has not been entirely examined. We aimed to investigate whether albuminuria and the eGFR using different biomarkers were associated with frailty. METHODS: A total of 1830 older adults were included. Kidney function was assessed by the eGFR (based on combined creatinine-cystatin C [eGFRcr-cys]) and β2-microglobulin [eGFRB2M]) and urine albumin-creatinine ratio (UACR). Frailty was measured by the Fried phenotype (FP) and frailty index (FI). Logistic regression models were used to investigate cross-sectional and longitudinal associations of baseline kidney measures with prevalent and incident frailty. RESULTS: At baseline, kidney function was associated with prevalent frailty. During the 2-year follow-up, a decreased eGFR (per 10 units) was associated with an increased risk of incident frailty using the FP (eGFRcr-cys: OR 1.18, 95% CI 1.03-1.35; eGFRB2M: OR 1.14, 95% CI 1.02-1.29, respectively) and FI (eGFRB2M: OR 1.18, 95% CI 1.04-1.65). An increased logUACR was associated with a higher risk of incident frailty using the FP (OR 1.18, 95% CI 1.03-1.35). Additionally, individuals with chronic kidney disease (CKD) had a higher risk of incident frailty using the FP (eGFRcr-cys: OR 2.13, 95% CI 1.28-3.47; eGFRB2M: OR 1.58, 95% CI 1.10-2.29, respectively) and FI (eGFRcr-cys: OR 1.97, 95% CI 1.15-3.32; eGFRB2M: OR 1.51, 95% CI 1.03-2.24, respectively). CONCLUSION: Kidney function decline and CKD were associated with an increased risk of prevalent and incident frailty in older adults. Physicians should pay more attention to monitoring frailty status in older adults with CKD, even in those with kidney function decline.
BACKGROUND AND AIM: A decreased estimated glomerular filtration rate (eGFR) is associated with frailty, but the association between kidney function and frailty using multidimensional assessments has not been entirely examined. We aimed to investigate whether albuminuria and the eGFR using different biomarkers were associated with frailty. METHODS: A total of 1830 older adults were included. Kidney function was assessed by the eGFR (based on combined creatinine-cystatin C [eGFRcr-cys]) and β2-microglobulin [eGFRB2M]) and urine albumin-creatinine ratio (UACR). Frailty was measured by the Fried phenotype (FP) and frailty index (FI). Logistic regression models were used to investigate cross-sectional and longitudinal associations of baseline kidney measures with prevalent and incident frailty. RESULTS: At baseline, kidney function was associated with prevalent frailty. During the 2-year follow-up, a decreased eGFR (per 10 units) was associated with an increased risk of incident frailty using the FP (eGFRcr-cys: OR 1.18, 95% CI 1.03-1.35; eGFRB2M: OR 1.14, 95% CI 1.02-1.29, respectively) and FI (eGFRB2M: OR 1.18, 95% CI 1.04-1.65). An increased logUACR was associated with a higher risk of incident frailty using the FP (OR 1.18, 95% CI 1.03-1.35). Additionally, individuals with chronic kidney disease (CKD) had a higher risk of incident frailty using the FP (eGFRcr-cys: OR 2.13, 95% CI 1.28-3.47; eGFRB2M: OR 1.58, 95% CI 1.10-2.29, respectively) and FI (eGFRcr-cys: OR 1.97, 95% CI 1.15-3.32; eGFRB2M: OR 1.51, 95% CI 1.03-2.24, respectively). CONCLUSION: Kidney function decline and CKD were associated with an increased risk of prevalent and incident frailty in older adults. Physicians should pay more attention to monitoring frailty status in older adults with CKD, even in those with kidney function decline.
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