Abstract: SA-PO0488
Assessment of Multidimensional Frailty and Its Mediating Effect on Adverse Prognosis in Older Adults with CKD
Session Information
- CKM: Clinical - Screening, Population Management, Care Disparities, and Patient-Centered Outcomes
October 24, 2026 | Location: Exhibit Hall A, Convention Center
Abstract Time: 10:00 AM - 12:00 PM
Category: Cardiovascular-Kidney-Metabolic Health
- 602 Cardiovascular-Kidney-Metabolic Health: Clinical
Authors
- Chen, Xujiao, Huashan Hospital Fudan University, Shanghai, China
- You, Huaizhou, Huashan Hospital Fudan University, Shanghai, China
- Chen, Jing, Huashan Hospital Fudan University, Shanghai, China
Background
Elderly patients with chronic kidney disease (CKD) are prone to a decline in multidimensional function, which is referred to as multidimensional frailty. This study aims to assess the manifestation of multidimensional frailty in elderly patients with CKD and its mediating effect on adverse prognosis.
Methods
We conducted a retrospective cohort study including patiens aged ≥60 years with CKD from Huashan Hospital, Fudan University from May 1, 2019 to December 31, 2019. Multidimensional Prognostic Index (MPI) was calculated and categorized into MPI-1 (low risk), MPI-2 (moderate risk), MPI-3 (high risk). Composite outcomes including cardiovascular disease (CVD) and all-cause mortality were recorded during the follow-up until June 30, 2024. Mediation analysis was conducted to investigate whether MPI mediates the association between CKD and composite outcomes. Net Reclassification Improvement (NRI) and Integrated Discrimination Improvement (IDI) was estimated the improvement of MPI-associated predictive model.
Results
A total of 323 patients with a median age of 76.2 years were enrolled. The average MPI value was 0.415, with 101 patients in MPI-1, 152 in MPI-2, and 70 in MPI-3 respectively. Domains including Activities of Daily Living (ADL), Instrumental ADL (IADL), Short Portable Mental Status Questionnaire (SPMSQ, Cumulative Illness Rating Scale (CIRS), number of medications and social support showed significant differences among different CKD stages. MPI risk was significantly correlated with stages of renal dysfunction and the the incidence of composite events. MPI showed a mediating effect of 39.5% between renal function and composite events. NRI and IDI indices suggested the significantly predictive ability of MPI for the composite endpoints, with the values of 0.246 and 0.062, respectively.
Conclusion
Multidimensional frailty was prevalent in elderly patients with CKD. MPI value increased markedly with worsening renal function and acted as a mediator between renal dysfunction and composite outcomes. MPI assessment can be suggested as a validated, accurate tool for helping early identification of frailty and predicting adverse prognosis in elderly patients with CKD.