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Glomerular filtration rate by different measures and albuminuria are associated with risk of frailty: the Rugao Longitudinal Ageing Study

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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.

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Acknowledgements

We acknowledge all participants involved in the present study from the RuLAS. We acknowledge the support from the government of Rugao, the Public Health Bureau of Jiang’an Township and Rugao city, the Bureau of Civil Affairs, the Rugao People’s Hospital and Human Phenome Institute, Fudan University, Shanghai, China.

Funding

This work was supported by grants from the National Key R&D Program of China (2018YFC2000400, 2018YFC2000400-3, 2018YFC2002000), the Shanghai Clinical Research Center for Aging and Medicine (19MC1910500), and Shanghai Municipal Science and Technology Major Project (2017SHZDZX01).

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Authors and Affiliations

  1. Human Phenome Institute and National Clinical Research Center for Aging and Medicine, Huashan Hospital, Fudan University, Shanghai, China

    Hui Zhang, Meng Hao, Yi Li, Xiaofeng Wang & Xuehui Sun

  2. Fudan University-the People’s Hospital of Rugao Joint Research Institute of Longevity and Aging, Rugao, Jiangsu, China

    Hui Zhang, Xiaofeng Wang & Xuehui Sun

  3. National Clinical Research Center for Aging and Medicine, Huashan Hospital, Fudan University, Shanghai, China

    Hui Zhang, Mengjing Wang, Jing Chen, Xiaofeng Wang & Xuehui Sun

  4. Key Laboratory of Arrhythmias, Ministry of Education, Department of Pathology and Pathophysiology, School of Medicine, Tongji University, Shanghai, China

    Xiaoyan Jiang

  5. Department of Nephrology, Huashan Hospital, Fudan University, Shanghai, China

    Mengjing Wang & Jing Chen

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  1. Hui Zhang
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  2. Meng Hao
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Contributions

ZH, SX and WXF: design research; ZH, LY, HM, JX, WM and CJ: conducted the research; ZH, LY and HM: analyzed the data, performed the tactical analyses. ZH and SX: wrote the paper; ZH and SX: had primary responsibility for the final content; and all authors read and approved the final manuscript.

Corresponding author

Correspondence to Xuehui Sun.

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This study was approved by the Human Ethics Committee of the School of Life Sciences of Fudan University.

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Written informed consent was obtained from all participants prior to the study.

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Zhang, H., Hao, M., Li, Y. et al. Glomerular filtration rate by different measures and albuminuria are associated with risk of frailty: the Rugao Longitudinal Ageing Study. Aging Clin Exp Res 34, 2703–2711 (2022). https://doi.org/10.1007/s40520-022-02245-2

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