Dataset Information

A prospective study of frailty in nephrology-referred patients with CKD.

ABSTRACT:

Background

Frailty is a construct developed to characterize a state of reduced functional capacity in older adults. However, there are limited data describing the prevalence or consequences of frailty in middle-aged patients with chronic kidney disease (CKD).

Study design

Observational study.

Setting & participants

336 non-dialysis-dependent patients with stages 1-4 CKD with estimated glomerular filtration rate (eGFR) <90 mL/min/1.73 m(2) (by the CKD-EPI [CKD Epidemiology Collaboration] serum creatinine-based equation) or evidence of microalbuminuria enrolled in the Seattle Kidney Study, a clinic-based cohort study. Findings were compared with community-dwelling older adults in the Cardiovascular Health Study.

Outcome

Prevalence and determinants of frailty in addition to its association with the combined outcome of all-cause mortality or renal replacement therapy.

Measurements

We defined frailty according to established criteria as 3 or more of the following characteristics: slow gait, weakness, unintentional weight loss, exhaustion, and low physical activity. We estimated kidney function using serum cystatin C concentrations (eGFR(cys)) to minimize confounding due to relationships of serum creatinine levels with muscle mass and frailty.

Results

The mean age of the study population was 59 years and mean eGFR(cys) was 51 mL/min/1.73 m(2). The prevalence of frailty (14.0%) was twice that of the much older non-CKD reference population (P < 0.01). The most common frailty components were physical inactivity and exhaustion. After adjustment including diabetes, eGFR(cys) categories of <30 and 30-44 mL/min/1.73 m(2) were associated with a 2.8- (95% CI, 1.3-6.3) and 2.1 (95% CI, 1.0-4.7)-fold greater prevalence of frailty compared with GFR(cys) ≥60 mL/min/1.73 m(2). There were 63 events during a median 987 days of follow-up. After adjustment, the frailty phenotype was associated with an estimated 2.5 (95% CI, 1.4-4.4)-fold greater risk of death or dialysis therapy.

Limitations

Cross-sectional study design obscures inference regarding temporal relationships between CKD and frailty.

Conclusions

Frailty is relatively common in middle-aged patients with CKD and is associated with lower eGFR(cys) and increased risk of death or dialysis therapy.

SUBMITTER: Roshanravan B

PROVIDER: S-EPMC3491110 | biostudies-literature | 2012 Dec

REPOSITORIES: biostudies-literature

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Publications

A prospective study of frailty in nephrology-referred patients with CKD.

Roshanravan Baback B Khatri Minesh M Robinson-Cohen Cassianne C Levin Greg G Patel Kushang V KV de Boer Ian H IH Seliger Stephen S Ruzinski John J Himmelfarb Jonathan J Kestenbaum Bryan B

American journal of kidney diseases : the official journal of the National Kidney Foundation 20120707 6

<h4>Background</h4>Frailty is a construct developed to characterize a state of reduced functional capacity in older adults. However, there are limited data describing the prevalence or consequences of frailty in middle-aged patients with chronic kidney disease (CKD).<h4>Study design</h4>Observational study.<h4>Setting & participants</h4>336 non-dialysis-dependent patients with stages 1-4 CKD with estimated glomerular filtration rate (eGFR) <90 mL/min/1.73 m(2) (by the CKD-EPI [CKD Epidemiology C ...[more]

PMID: 22770927

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Dataset Information

A prospective study of frailty in nephrology-referred patients with CKD.

Background

Study design

Setting & participants

Outcome

Measurements

Results

Limitations

Conclusions

Publications

A prospective study of frailty in nephrology-referred patients with CKD.

Similar Datasets

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