Frailty-related factors and 1-year renal function change after sodium-glucose cotransporter-2 inhibitors in elderly chronic kidney disease patients.

IF 3.5 3区医学 Q1 UROLOGY & NEPHROLOGY

Kidney Research and Clinical Practice Pub Date : 2026-09-01 Epub Date: 2025-12-08 DOI:10.23876/j.krcp.25.110

Hye-Mi Noh, Sei Hong Min, Hyung-Seok Lee, Sung Gyun Kim, Jun Goo Kang, Jwa-Kyung Kim

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引用次数: 0

Abstract

Background: Sodium-glucose cotransporter-2 inhibitors (SGLT2i) are first-line therapy for chronic kidney disease (CKD). However, evidence regarding their safety and efficacy in frail elderly patients remains limited. This study evaluated the impact of frailty-related factors on renal outcomes in elderly CKD patients treated with SGLT2i.

Methods: We retrospectively analyzed 302 elderly CKD patients (≥65 years) newly prescribed SGLT2i. Four frailty-related factors included advanced age (≥75 years), anemia, low Geriatric Nutritional Risk Index (GNRI ≤98), and proteinuria. Rapid renal decline was defined as an absolute decrease in estimated glomerular filtration rate (eGFR) >10 mL/min/1.73 m² within 12 months or a ≥40% reduction from baseline.

Results: The mean age was 75.7 ± 8.1 years, and baseline eGFR was 48.1 mL/min/1.73 m². Anemia was present in 49.3% and low GNRI in 12.3% of patients. Those with low GNRI were older, had lower BMI and serum albumin levels, higher prevalence of anemia and proteinuria, and greater 12‑month decline in eGFR (-4.0 mL/min/1.73 m2 vs. -2.0 mL/min/1.73 m2/year, p < 0.01). Rapid renal decline occurred in 29 patients (9.6%), and risk increased with accumulation of frailty factors. Advanced age (≥75 years) alone was associated with higher risk (odds ratio [OR], 2.34; 95% confidence interval [CI], 1.03-5.32), which further increased when combined with anemia and proteinuria (OR, 4.85; 95% CI, 2.19-10.77). Patients with all four components had the highest risk (OR, 9.70; 95% CI, 3.82-24.81).

Conclusion: While SGLT2i are generally effective in elderly CKD patients, those with frailty-related factors, particularly malnutrition, proteinuria, and anemia, appear to be at higher risk of rapid decline in renal function. These patients may benefit from more individualized risk assessment and management.

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老年慢性肾病患者服用钠-葡萄糖共转运蛋白-2抑制剂后1年肾功能变化与衰弱相关因素

背景：钠-葡萄糖共转运蛋白-2抑制剂（SGLT2i）是慢性肾脏疾病（CKD）的一线治疗药物。然而，关于它们在年老体弱患者中的安全性和有效性的证据仍然有限。本研究评估了衰弱相关因素对SGLT2i治疗的老年CKD患者肾脏预后的影响。方法：回顾性分析302例老年CKD患者（≥65岁）新开SGLT2i处方。4个衰弱相关因素包括高龄（≥75岁）、贫血、低老年营养风险指数（GNRI≤98）和蛋白尿。快速肾衰被定义为肾小球滤过率（eGFR）在12个月内绝对下降bbb10 mL/min/1.73 m²或比基线下降≥40%。结果：平均年龄为75.7 ± 8.1岁，基线eGFR为48.1 mL/min/1.73 m²。49.3%的患者出现贫血，12.3%的患者出现低GNRI。低GNRI患者年龄较大，BMI和血清白蛋白水平较低，贫血和蛋白尿患病率较高，eGFR 12个月下降幅度更大（-4.0 vs -2.0 ml/min/1.73m2/年，p ）结论：虽然SGLT2i通常对老年CKD患者有效，但那些有虚弱相关因素，特别是营养不良、蛋白尿和贫血的患者，肾功能快速下降的风险更高。这些患者可能受益于更个性化的风险评估和管理。

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

Kidney Research and Clinical Practice UROLOGY & NEPHROLOGY-

CiteScore

4.60

自引率

10.00%

发文量

审稿时长

10 weeks

期刊介绍： Kidney Research and Clinical Practice (formerly The Korean Journal of Nephrology; ISSN 1975-9460, launched in 1982), the official journal of the Korean Society of Nephrology, is an international, peer-reviewed journal published in English. Its ISO abbreviation is Kidney Res Clin Pract. To provide an efficient venue for dissemination of knowledge and discussion of topics related to basic renal science and clinical practice, the journal offers open access (free submission and free access) and considers articles on all aspects of clinical nephrology and hypertension as well as related molecular genetics, anatomy, pathology, physiology, pharmacology, and immunology. In particular, the journal focuses on translational renal research that helps bridging laboratory discovery with the diagnosis and treatment of human kidney disease. Topics covered include basic science with possible clinical applicability and papers on the pathophysiological basis of disease processes of the kidney. Original researches from areas of intervention nephrology or dialysis access are also welcomed. Major article types considered for publication include original research and reviews on current topics of interest. Accepted manuscripts are granted free online open-access immediately after publication, which permits its users to read, download, copy, distribute, print, search, or link to the full texts of its articles to facilitate access to a broad readership. Circulation number of print copies is 1,600.