ASN's Mission

To create a world without kidney diseases, the ASN Alliance for Kidney Health elevates care by educating and informing, driving breakthroughs and innovation, and advocating for policies that create transformative changes in kidney medicine throughout the world.

learn more

Contact ASN

1401 H St, NW, Ste 900, Washington, DC 20005

email@asn-online.org

202-640-4660

The Latest on Twitter

Kidney Week

Abstract: FR-PO928

Frailty Is Associated With Hospitalizations in Adults With CKD: Findings From the CRIC Study

Session Information

Category: CKD (Non-Dialysis)

  • 2201 CKD (Non-Dialysis): Epidemiology‚ Risk Factors‚ and Prevention

Authors

  • Hannan, Mary, University of Illinois Chicago College of Medicine, Chicago, Illinois, United States
  • Chen, Jinsong, University of Illinois Chicago College of Medicine, Chicago, Illinois, United States
  • Ricardo, Ana C., University of Illinois Chicago College of Medicine, Chicago, Illinois, United States
  • Saunders, Milda R., University of Chicago Department of Medicine, Chicago, Illinois, United States
  • Brown, Julia, University of Illinois Chicago College of Medicine, Chicago, Illinois, United States
  • Porter, Anna C., University of Illinois Chicago College of Medicine, Chicago, Illinois, United States
  • Lash, James P., University of Illinois Chicago College of Medicine, Chicago, Illinois, United States

Group or Team Name

  • The CRIC Study Investigators
Background

Adults with chronic kidney disease (CKD) experience high rates of hospitalization. Although the association between frailty and high hospitalization risk is established in the general population, it has not been examined in patients with CKD. The objective of this study is to evaluate frailty status as a predictor of hospitalizations in adults with CKD.

Methods

We utilized data on 2539 participants from the Chronic Renal Insufficiency Cohort (CRIC) Study. Frailty status was assessed using five criteria (slow gait speed, muscle weakness, low physical activity, exhaustion, and unintentional weight loss). Hospitalizations were ascertained based on self-report and review of medical records. Cardiovascular disease (CVD) hospitalizations were defined as those from a disease of the circulatory system. Analysis was conducted using multivariable Poisson regression adjusting for relevant covariates.

Results

Baseline age was 62.0 years, 46% were female, mean eGFR was 45.2 mL/min/1.73m2, and median urine protein was 0.2 mg/day. In the sample, 12% were frail, 51% pre-frail, and 37% non-frail. Over a median follow-up of 8.61 years, there were 19,630 hospitalizations. The rates of all-cause, CVD, and non-CVD related hospitalizations were highest for those who were frail. On multivariable analysis, both pre-frailty and frailty status were associated with having higher risk for all-cause, CVD, and non-CVD related hospitalizations.

Conclusion

Frailty status is associated with higher risk for hospitalizations in adults with CKD. Future work is needed to evaluate whether interventions to improve frailty status reduce the risk of hospitalization in this high risk population.

 Frailty StatusRate of Hospitalization
(per 100 person years)
Adjusted Rate Ratio
(95% CI)*
All Cause HospitalizationNon-frail16.4 (15.3,17.5)Reference
 Pre-frail25.8 (24.4,27.3)1.50 (1.43,1.58)
 Frail35.1 (31.3,39.4)1.92 (1.82,2.03)
CVD HospitalizationNon-frail4.7 (4.2,5.1)Reference
 Pre-frail8.0 (7.5,8.6)1.46 (1.34,1.58)
 Frail11.2 (9.9,12.8)1.83 (1.64,2.03)
Non-CVD HospitalizationNon-frail14.1 (13.1,15.1)Reference
 Pre-frail21.8 (20.6,23.1)1.52 (1.44,1.61)
 Frail30.3 (27.0,34.0)1.94 (1.83,2.07)

*Adjusted for clinical site, age, sex, race, ethnicity, education, marital status, smoking, BMI, SBP, DM, CVD, ACE/ARB, aspirin, statin, LDL, & baseline eGFR and proteinuria

Funding

  • NIDDK Support