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Estimated Glomerular Filtration Rate Decline and Incident Frailty in Older Adults

2019; Lippincott Williams & Wilkins; Volume: 14; Issue: 11 Linguagem: Inglês

10.2215/cjn.03750319

1555-905X

Florent Guerville, Philipe de Souto Barreto, Benjamin Taton, Isabelle Bourdel‐Marchasson, Yves Rolland, Bruno Vellas, Sophie Guyonnet, Isabelle Carrié, Lauréane Brigitte, Catherine Faisant, Françoise Lala, Julien Delrieu, Hélène Villars, Emeline Combrouze, Carole Badufle, Audrey Zueras. Methodology, Sandrine Andrieu, Christelle Cantet, Christophe Morin, Gabor Abellán van Kan, Charlotte Dupuy, Céline Caillaud, Pierre-Jean Ousset, Françoise Lala, Sherry L. Willis, A. Belleville, Brigitte Gilbert, Francine Fontaine, Jean‐François Dartigues, Isabelle Marcet, Fleur Delva, Alexandra Foubert, And Sandrine Cerda, Marie-Noëlle-Cuffi And Corinne Costes, Olivier Rouaud, Patrick Manckoundia, Valérie Quipourt, Sophie Marilier, And Evelyne Franon, Lawrence Bories, Marie-Laure Pader, Marie-France Basset, Bruno Lapoujade, Valérie Faure, Michael Li Yung Tong, Christine Malick-Loiseau, Evelyne Cazaban-Campistron, Françoise Desclaux, Colette Blatge, Thierry Dantoine, Cécile Laubarie-Mouret, Isabelle Saulnier, Jean‐Pierre Clément, Marie-Agnès Picat, Laurence Bernard‐Bourzeix, Stéphanie Willebois, Iléana Desormais, Noëlle Cardinaud, Marc Bonnefoy, Pierre Livet, Pascale Rebaudet, Claire Gédéon, Catherine Burdet, Flavien Terracol, Alain Pesce, Stéphanie Roth, Sylvie Chaillou, Sandrine Louchart, Kristelle Sudres, Nicolas Lebrun, Nadège Barro-Belaygues, Jacques Touchon, Karim Bennys, Audrey Gabelle, Aurélia Romano, Lynda Touati, Cécilia Marelli, Cécile Pays, Philippe Robert, Franck Le Duff, Claire Gervais, S. Gonfrier, Yannick Gasnier, Serge Bordes, Danièle Begorre, Christian Carpuat, Khaled Khales, Jean‐François Lefebvre, Samira Misbah El Idrissi, Pierre Skolil, Jean‐Pierre Salles, Carole Dufouil, Stéphane Lehericy, Marie Chupin, Jean‐François Mangin, Ali Bouhayia, Michèle Allard, F. Ricolfi, Dominique Dubois, Marie Martel, François Cotton, Alain Bonafé, S. Chanalet, Françoise Hugon, Fabrice Bonneville, Christophe Cognard, François Chollet, Pierre Payoux, Thierry Voisin, Julien Delrieu, Sophie Peiffer, Anne Hitzel, Michèle Allard, Michel Zanca, Jacques Monteil, Jacques Darcourt, Laurent Molinier, Hélène Derumeaux, Nadège Costa, Bertrand Perret, Claire Vinel, Sylvie Caspar‐Bauguil, Pascale Olivier, Sandrine Andrieu, Christelle Cantet, Nicola Coley,

Nutrition and Health in Aging

Background and objectives Low eGFR is known to be associated with frailty, but the association between the longitudinal decline of eGFR and incident frailty in older persons remains to be determined. The objective of this study was to investigate whether a fast decline on eGFR would be associated with incident frailty. Design, setting, participants, & measurements Community dwellers, aged ≥70, were included in this secondary analysis of the 5-year Multidomain Alzheimer Preventive Trial (MAPT). eGFR was calculated using CKD–Epidemiology Collaboration equation at baseline and at 6, 12, and 24 months. The lowest quartile of eGFR slope (−4.1 ml/min per 1.73 m 2 per yr) defined a fast decline. The frailty phenotype (unintentional weight loss, exhaustion, low physical activity, slow gait, low handgrip strength assessed with a 0–5 score, where higher is worse; a score ≥3 defines frailty) was assessed at baseline, 6, 12, 24, 36, 48, and 60 months. Cox models were used to test the association between fast eGFR decline and incident frailty. Results A total of 833 participants were frail neither at baseline nor at 2 years and had appropriate follow-up data. Median (IQR) baseline eGFR was 73 (61–84) ml/min per 1.73 m 2 . Frailty occurred in 95 (11%) participants between 24 and 60 months. Among them, 31/207 (15%) had fast eGFR decline between baseline and 24 months, and 64/626 (10%) did not. In a Cox model adjusted for demographic variables, cardiovascular comorbidity, C-reactive protein, and baseline eGFR, a fast eGFR decline was associated with incident frailty (HR 1.67, 95% CI 1.03 to 2.71). Sensitivity analyses provided consistent findings. Conclusions In community-dwelling older adults with relatively preserved baseline eGFR, a fast eGFR decline is associated with incident frailty.