Universität zu Köln

Meyer, Anna Maria ORCID: 0000-0002-5562-262X, Pickert, Lena, Heess, Annika, Becker, Ingrid ORCID: 0000-0001-5829-3553, Kurschat, Christine ORCID: 0000-0002-3646-9471, Bartram, Malte P., Benzing, Thomas ORCID: 0000-0003-0512-1066 and Polidori, Maria Cristina ORCID: 0000-0002-8881-904X (2022). Prognostic Signature of Chronic Kidney Disease in Advanced Age: Secondary Analysis from the InGAH Study with One-Year Follow-Up. Biomolecules, 12 (3). BASEL: MDPI. ISSN 2218-273X

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Abstract

The negative impact of chronic kidney disease (CKD) on health status and quality of life in older patients has been well documented. However, data on frailty trajectories and long-term outcomes of older CKD patients undergoing structured Comprehensive Geriatric Assessment (CGA) with multidimensional frailty evaluation are sparse. Here, we analysed records from 375 CKD patients admitted to our university hospital (mean age 77.5 (SD 6.1) years, 36% female) who had undergone a CGA-based calculation of the frailty score with the multidimensional prognostic index (MPI) as well as follow-up evaluations at 3, 6 and 12 months after discharge. Based on the MPI score at admission, 21% of the patients were frail and 56% were prefrail. MPI values were significantly associated with KDIGO CKD stages (p = 0.003) and rehospitalisation after 6 months (p = 0.027) and mortality at 3, 6 and 12 months (p = 0.001), independent of chronological age. Kidney transplant recipients (KTR) showed a significantly lower frailty compared to patients with renal replacement therapy (RRT, p = 0.028). The association between frailty and mortality after 12 months appeared particularly strong for KTR (mean MPI 0.43 KTR vs. 0.52 RRT, p < 0.001) and for patients with hypoalbuminemia (p < 0.001). Interestingly, RRT was per se not significantly associated with mortality during follow up. However, compared to patients on RRT those with KTR had a significantly lower grade of care (p = 0.031) and lower rehospitalisation rates at 12 months (p = 0.010). The present analysis shows that the large majority of older CKD inpatients are prefrail or frail and that the risk for CKD-related adverse outcomes on the long term can be accurately stratified by CGA-based instruments. Further studies are needed to explore the prognostic and frailty-related signature of laboratory biomarkers in CKD.

Item Type:	Journal Article
Creators:	Creators Email ORCID ORCID Put Code Meyer, Anna Maria UNSPECIFIED orcid.org/0000-0002-5562-262X UNSPECIFIED Pickert, Lena UNSPECIFIED UNSPECIFIED UNSPECIFIED Heess, Annika UNSPECIFIED UNSPECIFIED UNSPECIFIED Becker, Ingrid UNSPECIFIED orcid.org/0000-0001-5829-3553 UNSPECIFIED Kurschat, Christine UNSPECIFIED orcid.org/0000-0002-3646-9471 UNSPECIFIED Bartram, Malte P. UNSPECIFIED UNSPECIFIED UNSPECIFIED Benzing, Thomas UNSPECIFIED orcid.org/0000-0003-0512-1066 UNSPECIFIED Polidori, Maria Cristina UNSPECIFIED orcid.org/0000-0002-8881-904X UNSPECIFIED
URN:	urn:nbn:de:hbz:38-661756
DOI:	10.3390/biom12030423
Journal or Publication Title:	Biomolecules
Volume:	12
Number:	3
Date:	2022
Publisher:	MDPI
Place of Publication:	BASEL
ISSN:	2218-273X
Language:	English
Faculty:	Unspecified
Divisions:	Unspecified
Subjects:	no entry
Uncontrolled Keywords:	Keywords Language GLOMERULAR-FILTRATION-RATE; ONE-YEAR MORTALITY; NUTRITIONAL-STATUS; DIALYSIS PATIENTS; OLDER PATIENTS; FRAILTY; RISK; INDEX; ASSOCIATION; TRANSPLANT Multiple languages Biochemistry & Molecular Biology Multiple languages
URI:	http://kups.ub.uni-koeln.de/id/eprint/66175