Abstract
Association between Urine Albumin and Estimated Glomerular Filtration Rate with Incident Frailty in Healthy Older Adults: Secondary Analysis of the ASPREE Trial Cohort: TH-PO951
Journal of the American Society of Nephrology, Vol.35(10S)
10/2024
DOI: 10.1681/ASN.202444jyac6d
Abstract
Background:
Identifying risk factors for frailty may facilitate early diagnosis and intervention to preserve functional status. The association between estimated glomerular filtration rate (eGFR) and albuminuria (spot urine albumin to creatinine ratio, UACR) with incident frailty in generally healthy older individuals is unclear. This study aimed to investigate whether abnormal kidney function is associated with incident frailty assessed by the modified Fried frailty phenotype (FP), and, separately, a deficit accumulation frailty index (FI).
Methods:
This was asecondary analysis of 16,965 non-frail older adults aged ≥65 years in the ASPirin in Reducing Events in the Elderly (ASPREE) randomised trial cohort. Primary exposures were UACR, and eGFR calculated with the Chronic Kidney Disease Epidemiology Collaboration 2021 equation. Missing data in the FP was managed with multiple imputation. The primary outcome was time to incident frailty, analysed using multivariable adjusted discrete time survival analyses.
Results:
The mean age was 75.0 ± 4.5 years, median eGFR 78.5mL/min/1.73m2 (IQR 67.5, 89.3), and the median UACR was 0.80 mg/mmol (IQR 0.50, 1.50). In analyses using the FP, 950 people developed frailty over a median follow-up of 4.7 years (IQR 3.0, 5.0). Using the FI, 2,338 developed frailty over a median of 4.0 years (IQR 3.0, 5.0). The relationships between eGFR and both incident FP and FI was non-linear, such that an eGFR <45 or ≥75mL/min/1.73m2 was significantly associated with an increased risk of incident frailty. For every doubling of baseline UACR, risk of incident frailty increased by 4% using the FP (HR: 1.04, 95%CI:1.02-1.07) and the FI (HR: 1.04, 95%CI:1.01-1.07).
Conclusion:
In older adults, doubling of UACR, even at very low levels, was independently associated with incident frailty. Both low and high eGFR were associated with increased risk of incident frailty.
Details
- Title: Subtitle
- Association between Urine Albumin and Estimated Glomerular Filtration Rate with Incident Frailty in Healthy Older Adults: Secondary Analysis of the ASPREE Trial Cohort: TH-PO951
- Creators
- Elisa K. Bongetti - Monash HealthAnna Wilkinson - Monash UniversityJames B. Wetmore - Hennepin Healthcare Research InstituteAnne M. Murray - Hennepin Healthcare Research InstituteRobyn L. Woods - Monash UniversitySara E. Espinoza - Cedars-Sinai Medical CenterMichael E. Ernst - University of IowaMichelle A. Fravel - University of IowaSuzanne G. Orchard - Monash UniversityLe Thi Phuong Thao - Monash UniversityJoanne Ryan - Monash UniversityRory Wolfe - Monash UniversityKevan Polkinghorne - Monash University
- Resource Type
- Abstract
- Publication Details
- Journal of the American Society of Nephrology, Vol.35(10S)
- Publisher
- AMER SOC NEPHROLOGY; WASHINGTON
- DOI
- 10.1681/ASN.202444jyac6d
- ISSN
- 1046-6673
- eISSN
- 1533-3450
- Grant note
- NCINEIGovernment Support - Non-U.S.NIH - NIA
Other NIH Support - NIA, NCI, NEI, Government Support - Non-U.S.
- Language
- English
- Date published
- 10/2024
- Academic Unit
- Pharmacy Practice and Science; Family and Community Medicine
- Record Identifier
- 9984740954702771
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