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Kidney Week

Abstract: FR-PO898

Association of Polypharmacy and Incident Frailty Differs Between Older Adults with and Without CKD

Session Information

  • Geriatric Nephrology
    November 03, 2023 | Location: Exhibit Hall, Pennsylvania Convention Center
    Abstract Time: 10:00 AM - 12:00 PM

Category: Geriatric Nephrology

  • 1300 Geriatric Nephrology

Authors

  • Mielke, Nina, Charite Universitatsmedizin Berlin, Berlin, Germany
  • Barghouth, Muhammad, Charite Universitatsmedizin Berlin, Berlin, Germany
  • Fietz, Anne-Katrin, Charite Universitatsmedizin Berlin, Berlin, Germany
  • Villain, Cédric, Caen University Hospital, Caen, France
  • Bothe, Tim, Charite Universitatsmedizin Berlin, Berlin, Germany
  • Ebert, Natalie, Charite Universitatsmedizin Berlin, Berlin, Germany
  • Schaeffner, Elke, Charite Universitatsmedizin Berlin, Berlin, Germany
Background

Older adults with chronic kidney disease (CKD) have a high prevalence of comorbidities and are prone to polypharmacy. We aim to analyze if CKD modifies the association of polypharmacy and incident frailty.

Methods

Data from the Berlin Initiative (cohort) study were used, in which older adults (≥70 yrs.) were interviewed biennially using a standardized face-to-face questionnaire. Non-frail individuals were followed-up for 2 years and incident frailty according to Fried phenotype was assessed. Polypharmacy was defined as the intake of five or more regularly prescribed drugs and CKD as eGFRBIS2 <60 mL/min/1.73m2 or ACR ≥30 mg/g. Logistic regressions were used to analyze the association of polypharmacy and incident frailty to estimate crude and adjusted odds ratios (OR) and corresponding 95% confidence intervals (CI) in individuals with and without CKD.

Results

Individuals with CKD were older (84 vs. 81 years) and had more often hypertension (85 vs. 68%) or diabetes (25 vs. 13%) compared to individuals without CKD. After 2 years, fewer individuals without CKD became frail (7.5%) compared to individuals with CKD (19.7%), independent of their polypharmacy status. Individuals with CKD and polypharmacy became frail more frequently (26.7%) compared to individuals with CKD without polypharmacy (14.2%) (Table). In individuals without CKD, there was no difference in frailty incidence between those with (8.3%) and without (7.1%) polypharmacy.
In individuals with CKD, those with polypharmacy had 2.1 times the odds (95% CI 1.23–3.59) of becoming frail compared to those without. In old adults without CKD, we found no association between polypharmacy and incident frailty.

Conclusion

CKD modifies the effect of polypharmacy on frailty. In older adults with CKD, care providers should be aware of this interaction with polypharmacy and should consider initiating frailty prevention interventions early.

CKD modifies the association of polypharmacy and incident frailty

Funding

  • Private Foundation Support