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Abstract: PO2106

Frailty Is Associated with Higher Risk of Cardiovascular Events and Death in Adults with CKD: Findings from the Chronic Renal Insufficiency Cohort (CRIC) Study

Session Information

Category: Hypertension and CVD

  • 1402 Hypertension and CVD: Clinical, Outcomes, and Trials

Authors

  • Hannan, Mary, University of Illinois at Chicago College of Medicine, Chicago, Illinois, United States
  • Ricardo, Ana C., University of Illinois at Chicago College of Medicine, Chicago, Illinois, United States
  • Brown, Julia, University of Illinois at Chicago College of Medicine, Chicago, Illinois, United States
  • Carmona, Eunice, University of Illinois at Chicago College of Medicine, Chicago, Illinois, United States
  • Hajjiri, Zahraa, University of Illinois at Chicago College of Medicine, Chicago, Illinois, United States
  • Meza, Natalie, University of Illinois at Chicago College of Medicine, Chicago, Illinois, United States
  • Chen, Jinsong, University of Illinois at Chicago College of Medicine, Chicago, Illinois, United States
  • Saunders, Milda Renne, UChicago Medicine, Chicago, Illinois, United States
  • Lash, James P., University of Illinois at Chicago College of Medicine, Chicago, Illinois, United States
Background

Frailty is common in individuals with chronic kidney disease (CKD). In the general population, frailty is associated with increased risk of cardiovascular events and mortality, but this association has not been fully examined in the CKD population. The objective of this study is to evaluate frailty status as a predictor of cardiovascular events and death in individuals with CKD.

Methods

Among 2,537 CRIC Study participants, frailty status was assessed using five criteria (slow gait speed, muscle weakness, low physical activity, exhaustion, and unintentional weight loss). Frailty was defined as meeting ≥3 criteria, pre-frailty as meeting 1-2 criteria, and non-frailty as meeting zero criteria. Cox proportional hazards models were used to evaluate associations with atherosclerotic events, incident heart failure, and death.

Results

Baseline age was 57.5 years, 45.5% were female, mean eGFR was 46.9mL/min/1.73m2, and median urine protein was 0.13 mg/day. Frailty was present in 21% of the participants and 66% were pre-frail. During a median follow-up of 12.5 years, there were 349 atherosclerotic events, 398 incident heart failure events, and 398 deaths. In multivariable analyses, frail individuals had a higher risk of each outcome compared to non-frail individuals. Pre-frail individuals had a higher risk of atherosclerotic events compared to non-frail individuals (Table).

Conclusion

In adults with CKD, frailty is associated with increased risk for cardiovascular events and death. Future studies are needed to evaluate the impact of interventions to reduce frailty in individuals with CKD.

Association Between Frailty Status and Outcomes
 Atherosclerotic EventsHeart FailureDeath
 Hazard Ratio (95% CI)*
Pre-Frail1.73
(1.12 to 2.68)
1.36
(0.91 to 2.04)
1.47
(0.99 to 2.17)
Frail2.49
(1.56 to 3.98)
2.07
(1.35 to 3.17)
2.18
(1.44 to 3.31)
Non-FrailReferentReferentReferent

*Adjusted for clinical site, age, sex, race/ethnicity, education, marital status, smoking, BMI, systolic BP, diabetes mellitus, cardiovascular disease, LDL cholesterol, HDL cholesterol, ACE/ARB, aspirin, statin, baseline eGFR, and proteinuria

Funding

  • NIDDK Support