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Phosphate is associated with frailty in older patients with chronic kidney disease not on dialysis.

Authors :
Veloso MP
Coelho VA
Sekercioglu N
Moyses RMA
Elias RM
Source :
International urology and nephrology [Int Urol Nephrol] 2024 Aug; Vol. 56 (8), pp. 2725-2731. Date of Electronic Publication: 2024 Mar 18.
Publication Year :
2024

Abstract

Purpose: Frailty is common in older patients with chronic kidney disease (CKD) and has been considered an independent risk factor for adverse clinical outcomes in this population. CKD-associated mineral and bone metabolism (CKD-MBD) increases energy expenditure and causes malnutrition and inflammation leading to frailty. We investigated whether CKD-MBD markers and energy metabolism are associated with frailty in patients with advanced CKD on conservative management.<br />Methods: In this cross-sectional study, we investigated factors associated with frailty in a sample of 75 patients ≥ 65 years, with stage 4 or 5 CKD. Collected data included age, sex, body mass index, physical activity status, educational level, Charlson Comorbidity Index, and laboratory markers. Frailty was evaluated according to Fried's classification.<br />Results: Frailty was observed in 51.3% and pre-frailty in 47.3%. The frail population was significantly older, with a high proportion of females, more inactive, had lower educational levels, spent a long time sitting throughout the day, and had higher phosphate and fibroblast growth factor 21 (FGF-21). In the multivariate logistic analysis age (odds ratio 1.13, p = 0.026) and phosphate (odds ratio 3.38, p = 0.021) remained independently associated with frailty.<br />Conclusion: Serum phosphate seems to be a toxin associated with the frailty phenotype in older patients with CKD. Whether strategies to decrease serum phosphate would reduce the risk of frailty in this population deserves further evaluation.<br /> (© 2024. The Author(s), under exclusive licence to Springer Nature B.V.)

Details

Language :
English
ISSN :
1573-2584
Volume :
56
Issue :
8
Database :
MEDLINE
Journal :
International urology and nephrology
Publication Type :
Academic Journal
Accession number :
38498271
Full Text :
https://doi.org/10.1007/s11255-024-03985-y