Association of frailty with rapid kidney function decline in adults with normal kidney function

The association between frailty and kidney function remains poorly investigated. We aimed to evaluate the associations between frailty status and kidney function (rapid kidney function) decline and progressed to CKD in middle-aged and older Chinese population.

A total of 3,112 participants with eGFRcr-cys ≥60 ml/min per 1.73 m² and aged more than 60 years from the China Health and Retirement Longitudinal Study were included in analyses. Frailty was assessed using the Frailty Phenotype, which included assessments of unintentional weakness, slowness, exhaustion, low activity, and shrinking.

During the 4 years of follow-up, 499 (16.03%) participants experienced kidney function decline and 118 (3.79%) participants progressed to CKD. After multivariable adjustment of baseline eGFRcr-cys level and other risk factors, each 1-unit higher in frailty score was associated with 17% increased risk for the rapid decline in kidney function (annualized decline in eGFRcr-cys ≥3 ml/min per 1.73 m²). In addition, frailty was associated with an increased risk of rapid decline in kidney function (odds ratio = 1.17, 95% confidence interval:1.04-1.30). Individuals with slowness or exhaustion alone also had increased risk of rapid decline in kidney function.

Frailty was associated with increased risk of rapid decline in kidney function among Chinese adults with normal kidney function.