Relationship between chronic kidney disease with diabetes or hypertension and frailty in community-dwelling Japanese older adults

Aim: The aim of the present study was to evaluate the relationship between kidney function with concomitant diabetes or hypertension and frailty in community-dwelling Japanese older adults. Methods: The participants were 9606 residents (community-dwelling Japanese older adults) who completed baseline assessments. The estimated glomerular filtration rate (mL/min/1.73 m(2)) was determined according to the serum creatinine level, and participants were classified into four mutually exclusive categories: >60.0 (normal range), 45.0-59.9, 30.0-44.9 and <30.0 mL/min/1.73 m(2). Frailty status was defined using five criteria as described by Fried: slow gait speed, muscle weakness, low physical activity, exhaustion and unintentional weight loss. Participants who met three, four or five criteria satisfied the definition of having frailty. Multivariate logistic regression was used to examine the relationships between estimated glomerular filtration rate and frailty. Results: After multivariate adjustment, participants with lower kidney function (estimated glomerular filtration rate <30.0 mL/min/1.73 m(2)) were more frail (odds ratio [ORS 1.90, 95% confidence interval [CI] 1.01-3.59). In addition, individuals with a history of diabetes (OR 2.76, 95% CI 1.21-8.24) or hypertension (OR 2.53, 95% CI 1.45-5.12) showed a significantly increased risk of frailty in the lower kidney function group, regardless of multivariate controls. Furthermore, the analyses showed an even greater increase in the risk of frailty in patients with a history of both diabetes and hypertension (OR 3.67, 95% CI 1.13-14.1) Conclusions: A lower level of kidney function was associated with a higher risk of frailty in community-dwelling Japanese older adults.