Relationship of Frailty with Kidney Function in Adults More Than 60-Years-Old: Effect of Using Different Formulas to Estimate Glomerular Filtration Rate

Abstract

Objective

Determine the relationship of renal function with frailty using different formulas for estimated glomerular filtration rate (eGFR).

Methods

Individuals who were 60-years-old or more (n=507) were recruited from August 2020 to June 2021, and the FRAIL scale was used to classify them as non-frail or frail. The three equations used to compute the eGFR were based on serum creatinine (eGFRcr), cystatin C (eGFRcys), or SCr+CysC (eGFRcr-cys). Renal function was classified using eGFR and defined as normal (≥90 mL/min/1.73m ²), mild damage (59–89 mL/min/1.73m ²), or moderate damage (≤60 mL/min/1.73m ²). The relationship of frailty with renal function was analyzed. A subset of participants (n=358) was used to analyze changes in eGFR from 1 January 2012 to 31 December 2021 according to frailty and using the different eGFR equations.

Results

There were significant differences between the eGFRcr-cys and eGFRcr values in the frail group ( P<0.05), but not the non-frail group; however, the differences between the eGFRcr-cys and eGFRcys values were significant in the frail and non-frail groups ( P<0.001). Based on each eGFR equation, the prevalence of frailty increased as eGFR decreased ( P<0.001), but there was no significant relationship after adjusting for age or the age-adjusted Charlson co-morbidity index. There were temporal declines in eGFR in all three frailty groups (robust, pre-frail, and frail), especially in the frail group (2.226 mL/min/1.73m ² per year; P<0.001).

Conclusion

For older individuals who are frail, the eGFRcr value may not provide accurate estimates of renal function. Frailty is associated with a rapid decline in kidney function.