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 X

Kidney Week

ASN / Education & Meetings / Kidney Week /
Abstract: TH-PO951

Association between Urine Albumin and Estimated Glomerular Filtration Rate with Incident Frailty in Healthy Older Adults: Secondary Analysis of the ASPREE Trial Cohort

Session Information

Category: Geriatric Nephrology

  • 1300 Geriatric Nephrology

Authors

  • Bongetti, Elisa K., Department of Nephrology, Monash Health, Melbourne, Victoria, Australia
  • Wilkinson, Anna, School of Public Heath and Preventative Medicine, Monash University, Melbourne, Victoria, Australia
  • Wetmore, James B., Division of Nephrology, Hennepin Healthcare, Minneapolis, Minnesota, United States
  • Murray, Anne M., Berman Center for Outcomes and Clinical Research and Department of Medicine, Hennepin Healthcare Research Institute, and Department of Medicine, Geriatrics Division, Hennepin Healthcare Minneapolis, Minneapolis, Minnesota, United States
  • Woods, Robyn L., School of Public Heath and Preventative Medicine, Monash University, Melbourne, Victoria, Australia
  • Espinoza, Sara E., Center for Translational Geroscience, Department of Medicine, Cedars-Sinai Medical Center, Los Angeles, California, United States
  • Ernst, Michael E., Department of Pharmacy Practice and Science, College of Pharmacy; and, Department of Family Medicine, Carver College of Medicine. The University of Iowa, Iowa City, Iowa, United States
  • Fravel, Michelle A., Department of Pharmacy Practice and Science, College of Pharmacy; and, Department of Family Medicine, Carver College of Medicine. The University of Iowa, Iowa City, Iowa, United States
  • Orchard, Suzanne G., School of Public Heath and Preventative Medicine, Monash University, Melbourne, Victoria, Australia
  • Thao, Le Thi Phuong, School of Public Heath and Preventative Medicine, Monash University, Melbourne, Victoria, Australia
  • Ryan, Joanne, School of Public Heath and Preventative Medicine, Monash University, Melbourne, Victoria, Australia
  • Wolfe, Rory, School of Public Heath and Preventative Medicine, Monash University, Melbourne, Victoria, Australia
  • Polkinghorne, Kevan, Department of Nephrology, Monash Health, Melbourne, Victoria, Australia
Background

Identifying risk factors for frailty may facilitate early diagnosis and intervention to preserve functional status. The association between estimated glomerular filtration rate (eGFR) and albuminuria (spot urine albumin to creatinine ratio, UACR) with incident frailty in generally healthy older individuals is unclear. This study aimed to investigate whether abnormal kidney function is associated with incident frailty assessed by the modified Fried frailty phenotype (FP), and, separately, a deficit accumulation frailty index (FI).

Methods

This was a secondary analysis of 16,965 non-frail older adults aged ≥65 years in the ASPirin in Reducing Events in the Elderly (ASPREE) randomised trial cohort. Primary exposures were UACR, and eGFR calculated with the Chronic Kidney Disease Epidemiology Collaboration 2021 equation. Missing data in the FP was managed with multiple imputation. The primary outcome was time to incident frailty, analysed using multivariable adjusted discrete time survival analyses.

Results

The mean age was 75.0 ± 4.5 years, median eGFR 78.5mL/min/1.73m2 (IQR 67.5, 89.3), and the median UACR was 0.80 mg/mmol (IQR 0.50, 1.50). In analyses using the FP, 950 people developed frailty over a median follow-up of 4.7 years (IQR 3.0, 5.0). Using the FI, 2,338 developed frailty over a median of 4.0 years (IQR 3.0, 5.0). The relationships between eGFR and both incident FP and FI was non-linear, such that an eGFR <45 or ≥75mL/min/1.73m2 was significantly associated with an increased risk of incident frailty. For every doubling of baseline UACR, risk of incident frailty increased by 4% using the FP (HR: 1.04, 95%CI:1.02-1.07) and the FI (HR: 1.04, 95%CI:1.01-1.07).

Conclusion

In older adults, doubling of UACR, even at very low levels, was independently associated with incident frailty. Both low and high eGFR were associated with increased risk of incident frailty.

Funding

  • Other NIH Support