The association between frailty and chronic kidney disease; cross-sectional analysis of the Nambu Cohort Study

Abstract

Both frailty and chronic kidney disease (CKD) increase with age and share many similarities. Many studies have demonstrated an association between frailty and chronic kidney disease (CKD), but an association with dipstick proteinuria is limited. This is the cross-sectional analysis of the Nambu Cohort Study at the beginning of observation. Frailty was diagnosed using Kihon Checklist. Logistic analysis was used to evaluate the association between frailty and CKD or dipstick proteinuria. Among a total of 630 outpatients [age, 78 (70–84) years, men, 50%], the prevalence of patients with pre-frailty and frailty was 32% and 40%, respectively. The proportion of patients with pre-frailty and frailty increased with decreasing estimated glomerular filtration rate (eGFR) and increasing dipstick proteinuria levels. The odds ratios (95% confidence intervals) for CKD stage of 60\u2009<\u2009eGFR\u2009≤\u200945 ml/min/1.73 m2, and 45 ml/min/1.73 m2\u2009<\u2009eGFR for frailty was 0.87 (0.56–1.35) and 2.54 (1.46–4.53), respectively, compared with non-CKD as a reference. Furthermore, the odds ratios for the frailty of dipstick proteinuria with\u2009±\u2009and\u2009+\u2009or over were 1.36 (0.88–2.09) and 1.78 (1.00–3.17), respectively, when dipstick proteinuria—was used as a reference. Moreover, the combination of eGFR and dipstick proteinuria levels increased the odds ratio for pre-frailty and frailty. Elderly patients with CKD had a higher prevalence of pre-frailty and frailty. By adding urinary protein information to eGFR, the link between CKD and frailty becomes even more robust.