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Kidney Week

Abstract: FR-PO904

Relationship Between Frailty, Sodium, and Blood Pressure in Elderly People

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

  • D'Urbano, Luca, IRCCS Ospedale San Raffaele, Milano, Lombardia, Italy
  • Citterio, Lorena, IRCCS Ospedale San Raffaele, Milano, Lombardia, Italy
  • Zagato, Laura, IRCCS Ospedale San Raffaele, Milano, Lombardia, Italy
  • Concas, Maria Pina, IRCCS Materno Infantile Burlo Garofolo, Trieste, Friuli-Venezia Giulia, Italy
  • Simonini, Marco, IRCCS Ospedale San Raffaele, Milano, Lombardia, Italy
  • Lanzani, Chiara, IRCCS Ospedale San Raffaele, Milano, Lombardia, Italy
  • Manunta, Paolo, IRCCS Ospedale San Raffaele, Milano, Lombardia, Italy
Background

The objective of the FRASNET project is to investigate the correlation between frailty, natriuresis, and blood pressure (BP) in the elderly population to identify subgroups useful for diagnostic and therapeutic algorithms.

Methods

The FRASNET geriatric population (1204 subjects) is an Italian observational cohort that includes frail (35%), pre-frail (37.3%) and robust (27.7%) subjects. They have been characterized for BP, renal function, sodium intake (Kawasaki formula), cognitive status, quality of life (QoL), anamnestic factors, health and socio-economic status. ANOVA and conditional inference tree analysis have been carried out.

Results

745 participants out of 1203 (60%) were under anti-hypertensive treatment but 71.4% had a suboptimal control of BP. The significant elements are the male gender (p=0.002), waist circumference (p=0.01), visceral fat index (p<0.01), and fewer medications taken (p<0.01). An inferential analysis (Fig 1) evidenced a first dissection between males and females, a second one age-related (75 y) and a third with natriuresis (217 mEq Na). Non-frail subjects had the highest values for both systolic and diastolic BP; the frail group had the lowest values, below the 140 mmHg threshold. BPs negatively correlate with frailty status (systolic p=0.048, diastolic p <0.001, Fig 2).

Conclusion

The more severe the frailty, the lower the BP is supposed to be. The evidence of this inverse tendency is supported by physiological explanations and by therapeutic implications. Frail patients are usually more prone to injury; therefore, they are more likely to be prescribed more drugs and the most aggressive therapies to decrease risks. Ultimately, this correlation suggests that both conditions grant a relative decrease in risk with respect to the other one, at least when considering elder individuals.