Research Square · Sep 28, 2023
Relationships between cystatin C‑ and creatinine‑based eGFR in older adults with frailty
By Shi X, Wang S, Yang H et al.
Abstract Background Frailty is commonly observed in individuals with chronic kidney disease (CKD), as indicated by a decrease in physical function indicators such as grip strength and gait speed, which are linked to the estimated glomerular filtration rate (eGFR). Objective We hypothesizedthat the ratio of cystatin C-based eGFR (eGFRcys) to creatinine-based eGFR (eGFRcr) could serve as an indicator offrailty. Methods This cross-sectional study included 502 individuals(≥60). The Fried Frailty Phenotype (FFP) defines frailty. Receiver operating characteristic (ROC) curves were constructed to assess the predictive efficacy of the eGFRcys/eGFRcr and to calculatethe area under the curve (AUC). The cutoff value was determined to optimize both test sensitivity and specificity. Results The prevalence of frailty was 10.6%. The age-adjusted Charlson comorbidity index (ACCI) (OR=1.759, 95% CI 1.374-2.252), polypharmacy (OR=0.379,95% CI 0.190-0.755) and MNA-SF scores (OR=0.596,95% CI 0.488-0.729) were factors related tofrailty. ROC curve analysis showed that eGFRcys/eGFRcr had some predictive value for frailty, with an AUC of 0.665 (95% CI 0.622-0.706), a sensitivity of 60.38%, a specificity of 70.38%, and an optimal cutoff value of 0.3076. With the addition of MNA.SF, there was a significant increase in the AUC for diagnosing frailty to 0.749 (95% CI 0.709-0.786), with a sensitivity of 62.26% and specificity of 83.74%. Conclusion The prevalence of frailty is high among older individuals and is associated with several factors, including ACCI, polypharmacy and malnutrition. A combination of a lower eGFRcys/eGFRcre ratio and MNA. SF may serve as a potential marker for detecting frailty.