Association between frailty and chronic kidney disease: Findings from CHARLS

Abstract Objectives: To investigate prevalence of frailty in CKD individuals and the relationship between frailty and CKD based on a large, nationally representative survey. Design: Retrospective cohort study. Participants: The participants were 4231 adults aged ≥50 years from the China Health and Retirement Longitudinal Study (CHARLS). Measurements: Based on the FRAIL scale, frailty and prefrailty were defined. CKD was defined as eGFR less than 60 mL/min/1.73m2, calculated according to the CKD Epidemiology Collaboration (CKD-EPI) equation, or self-reported CKD. Logistic regression models were conducted to analyze the cross-sectional relationship between frailty and CKD. Cox proportional hazards regression models were used to examine the effect of frail status and frail components on CKD. Results: We found that prevalence of frailty in CKD individuals was 13.9% while in patients without CKD was 8.4%. The prevalence of CKD in robust group was 6.0%, in prefrail group was 10.1% and in frail group was 14.0%. In frail status, after adjusted, the incidence of CKD was 1.713 (95% CI 1.109-2.646) in the frail group compared with robust group (P =0.015). While there was no statistical difference in the incidence of CKD among the prefrail group and robust group. In frail components, after adjusted, weight loss was associated with higher risk of CKD HR (95% CI): 1.617 (1.170-2.235). Conclusion: The prevalence of frailty was relatively high in the population. In frail status, both prefrail and frail were associated with a higher risk of CKD. In frail components, weight loss was associated with an increase incidence of CKD. Frailty is reversible, so early identification of frailty may reduce the incidence of CKD and improve the adverse consequences associated with CKD.