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

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Abstract

Background

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.

Methods

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.

Results

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 < eGFR ≤ 45 ml/min/1.73 m2, and 45 ml/min/1.73 m2 < eGFR 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 ± and + or 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.

Conclusion

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.

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Acknowledgements

The authors are grateful to Ms. Makiko. Chinen, Ms. Masae Toma, Ms. Mitsue Nakajo, Ms. Asuka Kina, Ms. Minako Kikuyama, Ms. Megumi Ishiki, Ms. Mizuki Ohkata, Ms. Miwa Sunagawa, Ms. Minako Yamaniha, Ms. Masami Fukuyama, Ms. Minatsu Yamashiro, Ms. Megumi Kawabata, Ms. Sawako Sakugawa, Ms. Yuka Shimazaki, Ms. Kaori Unten, Ms. Mitsue Kuwae, Ms. Shoko Nagamine, Ms. Aya Henzan, Ms. Sayuri Matsumura, Ms. Yuko Kohno, Ms. Yoko Karakasa, Ms. Rie Kubota and Dr. Asuka Miiji for their dedicated work, and Mr. Makoto Ohmine for retrieving the data. Furthermore, the authors would like to thank Prof. Kunitoshi Iseki, Dr. Kazufumi Nagahama, and Dr. Masako Kochi for their valuable advice on the preparation of this paper. Finally, the authors extend their sincere appreciation to Mr. Kazuhide Nizato and Ms. Kuniko Inoue for their dedicated assistance.

Funding

The author(s) received no financial support for the research, authorship, and / or publication of this article.

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Authors and Affiliations

  1. Cardiovascular Medicine, Tomishiro Central Hospital, Taku Inoue: 25 Ueta, Tomigusuku City, Okinawa, 901-0243, Japan

    Taku Inoue & Tetsuji Shinjo

  2. Department of Preventive Medicine and Public Health, School of Medicine, Fukuoka University, Fukuoka, Japan

    Taku Inoue & Hisatomi Arima

  3. Matsuoka Clinic, Tomigusuku, Japan

    Mitsuteru Matsuoka

  4. Cardiovascular Medicine, Yuai Medical Center, Tomigusuku, Japan

    Masahiro Tamashiro, Kageyuki Oba & Osamu Arasaki

  5. Nanbu Medical Center, Haebaru, Japan

    Takuhiro Moromizato

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  1. Taku Inoue
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  2. Tetsuji Shinjo
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  3. Mitsuteru Matsuoka
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  4. Masahiro Tamashiro
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  5. Kageyuki Oba
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  7. Takuhiro Moromizato
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Contributions

TI, TS, and MM participated in study design. TI drafted the manuscript. TI and HA performed the statistical analysis. MT, KO, TM, and OA participated in study coordination. All authors read and approved the final manuscript.

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Correspondence to Taku Inoue.

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Inoue, T., Shinjo, T., Matsuoka, M. et al. The association between frailty and chronic kidney disease; cross-sectional analysis of the Nambu Cohort Study. Clin Exp Nephrol 25, 1311–1318 (2021). https://doi.org/10.1007/s10157-021-02110-y

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  • DOI: https://doi.org/10.1007/s10157-021-02110-y

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