Association between Frailty and Albuminuria Among Older Chinese Inpatients

Objectives Older adults with frailty are vulnerable to cardiovascular event and subsequent mortality. Frailty and albuminuria share atherosclerotic risk factors. The present study investigated the association of frailty and albuminuria among elderly Chinese inpatients. Design Cross-sectional study. Settings and participants A total of 202 patients aged over 60 years from the Center of Gerontology and Geriatric, West China Hospital. Measurements Frailty was defined using the five-item FRAIL scale. This included measurements of fatigue, resistance, ambulation, illness, and loss of weight. We further determined the random urine albumin/ creatinine ratio (UACR) of all patients. Random UACR >= 30 mg/g was defined as albuminuria, and < 30mg/g as normoalbuminuria. The relationship between albuminuria and frailty was assessed through multiple regression analysis. Results The 202 participants (156 men, 77.2%) had an average age of 78.99 +/- 7.60 years, which ranged from 60 to 95. Compared to those without albuminuria, elderly patients with albuminuria were of an older age, had a higher prevalence of diabetes and poorer renal function. The prevalence of frailty, pre-frailty and ambulation (one of the FRAIL components) were higher in the albuminuria group than the normoalbuminuria group (23.9% vs. 12.2%, 47.9% vs.37.4%, 33.8% vs. 16.0%, respectively, P<0.05). Following the adjustment for age, eGFR, hypertension, diabetes and using ACEI/ARB, being frail or pre-frail led to an enhanced risk of albuminuria (OR frail 2.60, 95% CI frail 1.01-6.72; OR pre-frail 2.14, 95% CI pre-frail 1.03-4.44). Conclusions Frailty is independently associated with albuminuria when adjusted for classic cardiovascular risk factors.