Prevalence and associated factors of frailty in patients with chronic kidney disease: a cross-sectional analysis of PEAKING study

Abstract

Aim Frailty is common and is reported to be associated with adverse outcomes in patients with chronic diseases in Western countries. However, the prevalence of frailty remains unclear in individuals with chronic kidney disease (CKD) in China. We examined the prevalence of frailty and factors associated with frailty in patients with CKD. Methods This was a cross-sectional analysis of 177 adult patients (mean age 54 ± 15 years, 52% men) with CKD from the open cohort entitled Physical Evaluation and Adverse outcomes for patients with chronic Kidney disease IN Guangdong (PEAKING). Frailty at baseline were assessed by FRAIL scale which included five items: fatigue, resistance, ambulation, illnesses, and loss of weight. Potential risk factors of frailty including age, sex, body mass index, and daily step counts recorded by ActiGraph GT3X + accelerometer were analyzed by multivariate logistic regression analysis. Results The prevalence of prefrailty and frailty was 50.0% and 11.9% in patients with stages 4–5 CKD, 29.6% and 9.3% in stage 3, and 32.1% and 0 in stages 1–2. In the multivariate logistic regression analysis, an increase of 100 steps per day (OR = 0.95, 95% CI 0.91–0.99, P = 0.01) and an increase of 5 units eGFR (OR = 0.82, 95% CI 0.68–0.99, P = 0.045) were inversely associated with being frail; higher BMI was associated with a higher likelihood of being frail (OR = 1.52, 95% CI 1.11–2.06, P = 0.008) and prefrail (OR = 1.25, 95% CI 1.10–1.42, P = 0.001). Conclusion Frailty and prefrailty were common in patients with advanced CKD. A lower number of steps per day, lower eGFR, and a higher BMI were associated with frailty in this population.

Interaction of general obesity and abdominal obesity with frailty in patients with chronic kidney disease: a nationally representative analysis

“…Previous studies have indicated that both general obesity, characterized by high body mass index (BMI), and abdominal obesity, characterized by increased waist circumference (WC), are associated with an increased risk of frailty in the elderly population [ 14 ]. However, this association remains less clear in the context of CKD, with inconsistent results [ 5 , 15 ]. Unlike the general population, CKD introduces a distinctive set of challenges in these associations, marked by altered metabolic states, dietary restrictions and nutritional imbalances [ 16 , 17 ].…”