Frailty Predicts an Increased Risk of End-Stage Renal Disease with Risk Competition by Mortality among 165,461 Diabetic Kidney Disease Patients.
chronic kidney disease
diabetes mellitus
diabetic kidney disease
dialysis
end-stage renal disease
frail phenotype
frailty
Journal
Aging and disease
ISSN: 2152-5250
Titre abrégé: Aging Dis
Pays: United States
ID NLM: 101540533
Informations de publication
Date de publication:
Dec 2019
Dec 2019
Historique:
received:
11
01
2019
accepted:
16
02
2019
entrez:
3
12
2019
pubmed:
4
12
2019
medline:
4
12
2019
Statut:
epublish
Résumé
To examine the effect of frailty on diabetic kidney disease patients' risk of progression to end-stage renal disease (ESRD), mortality, and adverse episodes, as whether frailty modifies their risk of developing ESRD and other adverse outcomes remains unclear. We identified 165,461 DKD patients from the Longitudinal Cohort of Diabetes Patients in Taiwan (n=840,000) between 2004 and 2010, classifying them into those without frailty or with 1, 2 and ≥3 frailty components based on a modified version of FRAIL scale. Using Cox proportional hazard regression analysis, we examined the long-term risk of developing ESRD along with their risk of mortality, supplemented by a competing risk analysis against mortality. Among all participants, 66.2% (n=109,586), 27.2% (n=44,986), 5.9% (n=9,799), and 0.7% (n=1090) patients did not have or had 1, 2, and ≥3 frailty components, respectively. After a 4.1-year follow-up, 4.2% patients developed ESRD and 18.5% died. Cox proportional hazard modeling revealed that patients with 1, 2, and ≥3 frailty components had increased risks of developing ESRD (for 1, 2, and ≥3 components, hazard ratio [HR] 1.13, 1.18, and 1.2, respectively) and mortality (HR 1.25, 1.41, and 1.34, respectively), with. 9% and 16% risk elevations for ESRD and mortality per component increase. Competing risk analysis showed that frailty-induced ESRD risk was attenuated partially by mortality in those with moderate frailty. The receipt of palliative care did not attenuate this risk. Frailty increased the risk of ESRD based on a dose-response relationship among DKD patients with risk competition by mortality.
Identifiants
pubmed: 31788338
doi: 10.14336/AD.2019.0216
pii: ad-10-6-1270
pmc: PMC6844590
doi:
Types de publication
Journal Article
Langues
eng
Pagination
1270-1281Informations de copyright
Copyright: © 2019 Chao et al.
Déclaration de conflit d'intérêts
Conflict of Interest The authors have no relevant financial or non-financial competing interests to declare in relation to this manuscript.
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