Prevalence and outcomes of fragility: a frailty-inflammation phenotype in children with chronic kidney disease.
Children
Chronic kidney disease
Frailty
Infection
Inflammation
Kidney disease progression
Nutrition
Journal
Pediatric nephrology (Berlin, Germany)
ISSN: 1432-198X
Titre abrégé: Pediatr Nephrol
Pays: Germany
ID NLM: 8708728
Informations de publication
Date de publication:
12 2019
12 2019
Historique:
received:
06
06
2019
accepted:
19
07
2019
revised:
17
07
2019
pubmed:
4
8
2019
medline:
25
8
2020
entrez:
4
8
2019
Statut:
ppublish
Résumé
Frailty is a condition of decreased physiologic reserve and increased vulnerability to stressors. Frailty in combination with inflammation has been associated with increased mortality risk in adults with advanced chronic kidney disease (CKD). This study aimed to investigate prevalence and outcomes associated with a frailty-inflammation phenotype, or "fragility," in children with CKD. We analyzed 557 children (age 6-19 years, eGFR 30-90 ml/min/1.73 m Prevalence of fragility indicators 1 year after study entry were 39% (suboptimal growth/weight gain), 62% (low muscle mass), 29% (fatigue), and 18% (inflammation). Prevalence of adverse outcomes during the subsequent 3 years were 13% (frequent infection), 22% (hospitalization), and 17% (rapid CKD progression). Children with ≥ 3 fragility indicators had 3.16-fold odds of frequent infection and 2.81-fold odds of hospitalization, but did not have rapid CKD progression. A fragility phenotype, characterized by the presence of ≥ 3 indicators, is associated with adverse outcomes, including infection and hospitalization in children with CKD.
Sections du résumé
BACKGROUND
Frailty is a condition of decreased physiologic reserve and increased vulnerability to stressors. Frailty in combination with inflammation has been associated with increased mortality risk in adults with advanced chronic kidney disease (CKD). This study aimed to investigate prevalence and outcomes associated with a frailty-inflammation phenotype, or "fragility," in children with CKD.
METHODS
We analyzed 557 children (age 6-19 years, eGFR 30-90 ml/min/1.73 m
RESULTS
Prevalence of fragility indicators 1 year after study entry were 39% (suboptimal growth/weight gain), 62% (low muscle mass), 29% (fatigue), and 18% (inflammation). Prevalence of adverse outcomes during the subsequent 3 years were 13% (frequent infection), 22% (hospitalization), and 17% (rapid CKD progression). Children with ≥ 3 fragility indicators had 3.16-fold odds of frequent infection and 2.81-fold odds of hospitalization, but did not have rapid CKD progression.
CONCLUSIONS
A fragility phenotype, characterized by the presence of ≥ 3 indicators, is associated with adverse outcomes, including infection and hospitalization in children with CKD.
Identifiants
pubmed: 31375914
doi: 10.1007/s00467-019-04313-8
pii: 10.1007/s00467-019-04313-8
pmc: PMC6819247
mid: NIHMS1536485
doi:
Types de publication
Journal Article
Research Support, N.I.H., Extramural
Langues
eng
Sous-ensembles de citation
IM
Pagination
2563-2569Subventions
Organisme : NIDDK NIH HHS
ID : U01 DK066143
Pays : United States
Organisme : NIDDK NIH HHS
ID : U01 DK066116
Pays : United States
Organisme : NIDDK NIH HHS
ID : U01 DK066174
Pays : United States
Organisme : NIDDK NIH HHS
ID : U24 DK066116
Pays : United States
Organisme : NIDDK NIH HHS
ID : U24 DK082194
Pays : United States
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