Associations between frailty, genetic predisposition, and chronic kidney disease risk in middle-aged and older adults: A prospective cohort study

IF 4.3 3区材料科学 Q1 ENGINEERING, ELECTRICAL & ELECTRONIC

ACS Applied Electronic Materials Pub Date : 2024-06-24 DOI:10.1016/j.maturitas.2024.108059

Honghao Yang , Zhenhua Li , Yixiao Zhang , Qing Chang , Jinguo Jiang , Yashu Liu , Chao Ji , Liangkai Chen , Yang Xia , Yuhong Zhao

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Abstract

Objectives

Cross-sectional evidence has shown that frailty is highly prevalent in patients with chronic kidney disease (CKD). However, there is limited evidence of the longitudinal associations between frailty, genetic predisposition to CKD, and the risk of CKD in the general population. Therefore, this study aimed to examine such associations among participants in the UK Biobank.

Study design

This is a prospective cohort study included 370,965 middle-aged and older adults from the UK Biobank. Physical frailty was assessed using a modified version of the Fried phenotype classification. A weighted genetic risk score was built using 263 variants associated with estimated glomerular filtration rate.

Main outcome measures

Incident CKD was identified from hospital inpatient records.

Results

Over a median follow-up of 12.3 years, we documented a total of 11,121 incident CKD cases. Time-dependent Cox proportional hazards regression models indicated that individuals with frailty (hazard ratio [HR]: 1.94, 95 % confidence interval [CI]: 1.81–2.08) and pre-frailty (HR: 1.27, 95 % CI: 1.22–1.33) had an increased risk of developing CKD, compared with non-frail individuals. No significant interaction between frailty and genetic risk score was observed (P for interaction = 0.41). The highest risk was observed among the individuals with high genetic risk and frailty (HR: 2.31, 95 % CI: 2.00–2.68).

Conclusion

Our results demonstrated that frailty and pre-frailty were associated with increased risk of incident CKD in middle-age and older adults, regardless of genetic risk of CKD. Our study underscores the importance of frailty screening and intervention as a potential strategy to prevent CKD. Future clinical trials are needed to validate our findings.

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中老年人体弱、遗传易感性与慢性肾病风险之间的关系：前瞻性队列研究。

目的：横断面证据显示，虚弱在慢性肾脏病（CKD）患者中非常普遍。然而，有关虚弱、CKD 遗传易感性和普通人群 CKD 风险之间纵向关联的证据却很有限。因此，本研究旨在考察英国生物库参与者中的这种关联：这是一项前瞻性队列研究，研究对象包括英国生物库中的 370965 名中老年人。身体虚弱采用弗里德表型分类法的修订版进行评估。利用与估计肾小球滤过率相关的 263 个变异建立了加权遗传风险评分：主要结果测量：从医院住院病人记录中确定是否发生 CKD：结果：在中位 12.3 年的随访期间，我们共记录了 11121 例突发 CKD 病例。与时间相关的考克斯比例危险回归模型显示，与非体弱者相比，体弱者（危险比 [HR]：1.94，95% 置信区间 [CI]：1.81-2.08）和体弱前期（HR：1.27，95% 置信区间 [CI]：1.22-1.33）罹患 CKD 的风险更高。在虚弱与遗传风险评分之间没有观察到明显的交互作用（交互作用的 P = 0.41）。遗传风险高且体弱的个体风险最高（HR：2.31，95 % CI：2.00-2.68）：我们的研究结果表明，无论中老年人的 CKD 遗传风险如何，虚弱和虚弱前期与中老年人发生 CKD 的风险增加有关。我们的研究强调了虚弱筛查和干预作为预防慢性肾脏病潜在策略的重要性。未来还需要进行临床试验来验证我们的研究结果。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

ACS Applied Electronic Materials Multiple-

CiteScore

7.20

自引率

4.30%

发文量

567