Abstract: PO0765
CKD-Associated Frailty Risk Trajectory over Time Among Patients with Newly Diagnosed Diabetes Mellitus: A Population-Based Cohort Analysis
Session Information
- Diabetic Kidney Disease: Clinical
November 04, 2021 | Location: On-Demand, Virtual Only
Abstract Time: 10:00 AM - 12:00 PM
Category: Diabetic Kidney Disease
- 602 Diabetic Kidney Disease: Clinical
Author
- Chao, Chia-Ter, National Taiwan University Hospital Beihu Branch, Taipei, Taiwan
Background
Patients with chronic kidney disease (CKD) and diabetes mellitus (DM) are at high risk of frailty and adverse functional outcomes. CKD likely further aggravates the risk of frailty among patients with DM. However, whether the timing of CKD onset relative to incident DM affects the subsequent risk of frailty over time remains unclear.
Methods
We recruited patients with newly diagnosed DM but without frailty from a population-based cohort (n=488,458), dividing them into those without CKD throughout study period (7 years), with CKD prior to DM diagnosis, and with CKD years after incident DM. Their risk of frailty, based on a modified FRAIL scale, were examined. We used Cox proportional hazard regression to calculate CKD-associated risk of frailty, accounting for demographic, morbidities, medication, and prior hospitalization, followed by multiple regression analyses to calculate the annual probability of developing frailty starting immediately after DM occurrence.
Results
Among the enrolled patients with newly diagnosed DM, 80.8% (n=394,673) had no CKD throughout study period, while 3.3% (n=16,037) and 15.9% (n=77,748) had CKD prior to and after DM, respectively. Cox proportional hazard regression showed that newly diagnosed diabetic patients with CKD after DM had a significantly higher risk of developing frailty than those without CKD throughout study period (hazard ratio [HR] 1.649, 95% confidence interval [CI] 1.45 – 1.88), while those with CKD before DM had a higher but rather modest risk (HR 1.200, 95% CI 1.11 - 1.29). The annual probability of frailty occurrence was highest early during the course of DM and decreased slowly but gradually among CKD after DM group, while that of frailty remained stable throughout the study period among CKD prior to DM group (Figure).
Conclusion
The risk of CKD-related frailty exhibited temporal changes in patients with newly diagnosed DM. It would be prudent to carefully select the timing of providing frailty-oriented care in these patients.