Prevalence and outcomes of fragility: a frailty-inflammation phenotype in children with chronic kidney disease
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...
Gespeichert in:
| Veröffentlicht in: | Pediatric nephrology (Berlin, West) West), 2019-12, Vol.34 (12), p.2563-2569 |
|---|---|
| Hauptverfasser: | , , , , , |
| Format: | Artikel |
| Sprache: | eng |
| Schlagworte: | |
| Online-Zugang: | Volltext |
| Tags: |
Tag hinzufügen
Keine Tags, Fügen Sie den ersten Tag hinzu!
|
| container_end_page | 2569 |
|---|---|
| container_issue | 12 |
| container_start_page | 2563 |
| container_title | Pediatric nephrology (Berlin, West) |
| container_volume | 34 |
| creator | Sgambat, Kristen Matheson, Matthew B. Hooper, Stephen R. Warady, Bradley Furth, Susan Moudgil, Asha |
| description | 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
2
) from the Chronic Kidney Disease in Children (CKiD) study. Based on adult models, the CKiD fragility model included four indicators: (1) suboptimal growth/weight gain (BMI 30% or initiation of renal replacement therapy within 3 years).
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. |
| doi_str_mv | 10.1007/s00467-019-04313-8 |
| format | Article |
| fullrecord | <record><control><sourceid>gale_pubme</sourceid><recordid>TN_cdi_pubmedcentral_primary_oai_pubmedcentral_nih_gov_6819247</recordid><sourceformat>XML</sourceformat><sourcesystem>PC</sourcesystem><galeid>A607985136</galeid><sourcerecordid>A607985136</sourcerecordid><originalsourceid>FETCH-LOGICAL-c610t-96087bc44494628089fc950f90326da1189ba2b5af29057c42b6bc993f1cbc603</originalsourceid><addsrcrecordid>eNp9kl9v1SAYxhujccfpF_DCkJiY3XQCbSl4YbIs80-yRC802R2h9G3LpHCEdqbfXuqZ2445MVwQeH_vAzw8WfaS4FOCcf02YlyyOsdE5LgsSJHzR9mGlAXNieBXj7MNFgVJJXJ1lD2L8RpjzCvOnmZHCa4rQcpN5r4GuFEWnAakXIv8PGk_QkS-Q11QvbFmWt4htS6MnZbcuM6qcVST8Q5tB3B-WraAjEN6MLYN4NAvMw1pFbwzGv0wrYMFtSaCivA8e9IpG-HF7Xycff9w8e38U3755ePn87PLXDOCp1wwzOtGl2UpSkY55qLTosKdwAVlrSKEi0bRplIdFbiqdUkb1mghio7oRjNcHGfvd7rbuRmh1eCmoKzcBjOqsEivjNyvODPI3t9IxomgZZ0ETm4Fgv85Q5zkaKIGa5UDP0dJKePJRUqKhL7-B732c3DpeStVC1ELVt9TfXJbJhd9OlevovKM4VrwihQsUfkBqgcH6ZLeQWfS9h5_eoBPo4XR6IMNbx40DKDsNERv5_U74z5Id6AOPsYA3Z15BMs1fnIXP5niJ__ET_LU9Oqh7Xctf_OWgGIHxFRyPYR7r_4j-xsGMuSO</addsrcrecordid><sourcetype>Open Access Repository</sourcetype><iscdi>true</iscdi><recordtype>article</recordtype><pqid>2267997967</pqid></control><display><type>article</type><title>Prevalence and outcomes of fragility: a frailty-inflammation phenotype in children with chronic kidney disease</title><source>SpringerLink Journals - AutoHoldings</source><creator>Sgambat, Kristen ; Matheson, Matthew B. ; Hooper, Stephen R. ; Warady, Bradley ; Furth, Susan ; Moudgil, Asha</creator><creatorcontrib>Sgambat, Kristen ; Matheson, Matthew B. ; Hooper, Stephen R. ; Warady, Bradley ; Furth, Susan ; Moudgil, Asha</creatorcontrib><description>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
2
) from the Chronic Kidney Disease in Children (CKiD) study. Based on adult models, the CKiD fragility model included four indicators: (1) suboptimal growth/weight gain (BMI < 5th percentile-for-height-age, deceleration ≥ 10 BMI-for-height-age percentiles/1 year, height-for-age percentile < 3rd or deceleration ≥ 10 height percentiles/1 year); (2) low muscle mass (mid-upper-arm circumference < 5th percentile or deceleration ≥ 10 percentiles/1 year); (3) fatigue (parent/child report); (4) inflammation (CRP > 3 mg/l). Logistic regression was used to evaluate association of fragility indicators with three adverse outcomes: frequent infection (> 1 per year/3 years), hospitalization (any), and rapid CKD progression (decline in eGFR > 30% or initiation of renal replacement therapy within 3 years).
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.</description><identifier>ISSN: 0931-041X</identifier><identifier>EISSN: 1432-198X</identifier><identifier>DOI: 10.1007/s00467-019-04313-8</identifier><identifier>PMID: 31375914</identifier><language>eng</language><publisher>Berlin/Heidelberg: Springer Berlin Heidelberg</publisher><subject>Age ; Arm ; Arm circumference ; Children ; Chronic kidney failure ; Development and progression ; Diseases ; Distribution ; Epidermal growth factor receptors ; Fatigue ; Frailty ; Genotype & phenotype ; Hospitalization ; Infections ; Inflammation ; Kidney diseases ; Medicine ; Medicine & Public Health ; Nephrology ; Original Article ; Patient outcomes ; Pediatrics ; Phenotypes ; Urology ; What’s New in Chronic Kidney Disease</subject><ispartof>Pediatric nephrology (Berlin, West), 2019-12, Vol.34 (12), p.2563-2569</ispartof><rights>IPNA 2019</rights><rights>COPYRIGHT 2019 Springer</rights><rights>Pediatric Nephrology is a copyright of Springer, (2019). All Rights Reserved.</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c610t-96087bc44494628089fc950f90326da1189ba2b5af29057c42b6bc993f1cbc603</citedby><cites>FETCH-LOGICAL-c610t-96087bc44494628089fc950f90326da1189ba2b5af29057c42b6bc993f1cbc603</cites><orcidid>0000-0003-0795-3210</orcidid></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://link.springer.com/content/pdf/10.1007/s00467-019-04313-8$$EPDF$$P50$$Gspringer$$H</linktopdf><linktohtml>$$Uhttps://link.springer.com/10.1007/s00467-019-04313-8$$EHTML$$P50$$Gspringer$$H</linktohtml><link.rule.ids>230,314,780,784,885,27924,27925,41488,42557,51319</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/31375914$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Sgambat, Kristen</creatorcontrib><creatorcontrib>Matheson, Matthew B.</creatorcontrib><creatorcontrib>Hooper, Stephen R.</creatorcontrib><creatorcontrib>Warady, Bradley</creatorcontrib><creatorcontrib>Furth, Susan</creatorcontrib><creatorcontrib>Moudgil, Asha</creatorcontrib><title>Prevalence and outcomes of fragility: a frailty-inflammation phenotype in children with chronic kidney disease</title><title>Pediatric nephrology (Berlin, West)</title><addtitle>Pediatr Nephrol</addtitle><addtitle>Pediatr Nephrol</addtitle><description>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
2
) from the Chronic Kidney Disease in Children (CKiD) study. Based on adult models, the CKiD fragility model included four indicators: (1) suboptimal growth/weight gain (BMI < 5th percentile-for-height-age, deceleration ≥ 10 BMI-for-height-age percentiles/1 year, height-for-age percentile < 3rd or deceleration ≥ 10 height percentiles/1 year); (2) low muscle mass (mid-upper-arm circumference < 5th percentile or deceleration ≥ 10 percentiles/1 year); (3) fatigue (parent/child report); (4) inflammation (CRP > 3 mg/l). Logistic regression was used to evaluate association of fragility indicators with three adverse outcomes: frequent infection (> 1 per year/3 years), hospitalization (any), and rapid CKD progression (decline in eGFR > 30% or initiation of renal replacement therapy within 3 years).
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.</description><subject>Age</subject><subject>Arm</subject><subject>Arm circumference</subject><subject>Children</subject><subject>Chronic kidney failure</subject><subject>Development and progression</subject><subject>Diseases</subject><subject>Distribution</subject><subject>Epidermal growth factor receptors</subject><subject>Fatigue</subject><subject>Frailty</subject><subject>Genotype & phenotype</subject><subject>Hospitalization</subject><subject>Infections</subject><subject>Inflammation</subject><subject>Kidney diseases</subject><subject>Medicine</subject><subject>Medicine & Public Health</subject><subject>Nephrology</subject><subject>Original Article</subject><subject>Patient outcomes</subject><subject>Pediatrics</subject><subject>Phenotypes</subject><subject>Urology</subject><subject>What’s New in Chronic Kidney Disease</subject><issn>0931-041X</issn><issn>1432-198X</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2019</creationdate><recordtype>article</recordtype><sourceid>ABUWG</sourceid><sourceid>AFKRA</sourceid><sourceid>AZQEC</sourceid><sourceid>BENPR</sourceid><sourceid>CCPQU</sourceid><recordid>eNp9kl9v1SAYxhujccfpF_DCkJiY3XQCbSl4YbIs80-yRC802R2h9G3LpHCEdqbfXuqZ2445MVwQeH_vAzw8WfaS4FOCcf02YlyyOsdE5LgsSJHzR9mGlAXNieBXj7MNFgVJJXJ1lD2L8RpjzCvOnmZHCa4rQcpN5r4GuFEWnAakXIv8PGk_QkS-Q11QvbFmWt4htS6MnZbcuM6qcVST8Q5tB3B-WraAjEN6MLYN4NAvMw1pFbwzGv0wrYMFtSaCivA8e9IpG-HF7Xycff9w8e38U3755ePn87PLXDOCp1wwzOtGl2UpSkY55qLTosKdwAVlrSKEi0bRplIdFbiqdUkb1mghio7oRjNcHGfvd7rbuRmh1eCmoKzcBjOqsEivjNyvODPI3t9IxomgZZ0ETm4Fgv85Q5zkaKIGa5UDP0dJKePJRUqKhL7-B732c3DpeStVC1ELVt9TfXJbJhd9OlevovKM4VrwihQsUfkBqgcH6ZLeQWfS9h5_eoBPo4XR6IMNbx40DKDsNERv5_U74z5Id6AOPsYA3Z15BMs1fnIXP5niJ__ET_LU9Oqh7Xctf_OWgGIHxFRyPYR7r_4j-xsGMuSO</recordid><startdate>20191201</startdate><enddate>20191201</enddate><creator>Sgambat, Kristen</creator><creator>Matheson, Matthew B.</creator><creator>Hooper, Stephen R.</creator><creator>Warady, Bradley</creator><creator>Furth, Susan</creator><creator>Moudgil, Asha</creator><general>Springer Berlin Heidelberg</general><general>Springer</general><general>Springer Nature B.V</general><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>3V.</scope><scope>7QP</scope><scope>7RV</scope><scope>7X7</scope><scope>7XB</scope><scope>88E</scope><scope>8AO</scope><scope>8FI</scope><scope>8FJ</scope><scope>8FK</scope><scope>ABUWG</scope><scope>AFKRA</scope><scope>AZQEC</scope><scope>BENPR</scope><scope>CCPQU</scope><scope>FYUFA</scope><scope>GHDGH</scope><scope>K9-</scope><scope>K9.</scope><scope>KB0</scope><scope>M0R</scope><scope>M0S</scope><scope>M1P</scope><scope>NAPCQ</scope><scope>PQEST</scope><scope>PQQKQ</scope><scope>PQUKI</scope><scope>7X8</scope><scope>5PM</scope><orcidid>https://orcid.org/0000-0003-0795-3210</orcidid></search><sort><creationdate>20191201</creationdate><title>Prevalence and outcomes of fragility: a frailty-inflammation phenotype in children with chronic kidney disease</title><author>Sgambat, Kristen ; Matheson, Matthew B. ; Hooper, Stephen R. ; Warady, Bradley ; Furth, Susan ; Moudgil, Asha</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c610t-96087bc44494628089fc950f90326da1189ba2b5af29057c42b6bc993f1cbc603</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2019</creationdate><topic>Age</topic><topic>Arm</topic><topic>Arm circumference</topic><topic>Children</topic><topic>Chronic kidney failure</topic><topic>Development and progression</topic><topic>Diseases</topic><topic>Distribution</topic><topic>Epidermal growth factor receptors</topic><topic>Fatigue</topic><topic>Frailty</topic><topic>Genotype & phenotype</topic><topic>Hospitalization</topic><topic>Infections</topic><topic>Inflammation</topic><topic>Kidney diseases</topic><topic>Medicine</topic><topic>Medicine & Public Health</topic><topic>Nephrology</topic><topic>Original Article</topic><topic>Patient outcomes</topic><topic>Pediatrics</topic><topic>Phenotypes</topic><topic>Urology</topic><topic>What’s New in Chronic Kidney Disease</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Sgambat, Kristen</creatorcontrib><creatorcontrib>Matheson, Matthew B.</creatorcontrib><creatorcontrib>Hooper, Stephen R.</creatorcontrib><creatorcontrib>Warady, Bradley</creatorcontrib><creatorcontrib>Furth, Susan</creatorcontrib><creatorcontrib>Moudgil, Asha</creatorcontrib><collection>PubMed</collection><collection>CrossRef</collection><collection>ProQuest Central (Corporate)</collection><collection>Calcium & Calcified Tissue Abstracts</collection><collection>ProQuest Nursing & Allied Health Database</collection><collection>ProQuest Health & Medical Collection</collection><collection>ProQuest Central (purchase pre-March 2016)</collection><collection>Medical Database (Alumni Edition)</collection><collection>ProQuest Pharma Collection</collection><collection>Hospital Premium Collection</collection><collection>Hospital Premium Collection (Alumni Edition)</collection><collection>ProQuest Central (Alumni) (purchase pre-March 2016)</collection><collection>ProQuest Central (Alumni)</collection><collection>ProQuest Central UK/Ireland</collection><collection>ProQuest Central Essentials</collection><collection>ProQuest Central</collection><collection>ProQuest One Community College</collection><collection>Health Research Premium Collection</collection><collection>Health Research Premium Collection (Alumni)</collection><collection>Consumer Health Database (Alumni Edition)</collection><collection>ProQuest Health & Medical Complete (Alumni)</collection><collection>Nursing & Allied Health Database (Alumni Edition)</collection><collection>ProQuest Consumer Health Database</collection><collection>Health & Medical Collection (Alumni Edition)</collection><collection>PML(ProQuest Medical Library)</collection><collection>Nursing & Allied Health Premium</collection><collection>ProQuest One Academic Eastern Edition (DO NOT USE)</collection><collection>ProQuest One Academic</collection><collection>ProQuest One Academic UKI Edition</collection><collection>MEDLINE - Academic</collection><collection>PubMed Central (Full Participant titles)</collection><jtitle>Pediatric nephrology (Berlin, West)</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Sgambat, Kristen</au><au>Matheson, Matthew B.</au><au>Hooper, Stephen R.</au><au>Warady, Bradley</au><au>Furth, Susan</au><au>Moudgil, Asha</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Prevalence and outcomes of fragility: a frailty-inflammation phenotype in children with chronic kidney disease</atitle><jtitle>Pediatric nephrology (Berlin, West)</jtitle><stitle>Pediatr Nephrol</stitle><addtitle>Pediatr Nephrol</addtitle><date>2019-12-01</date><risdate>2019</risdate><volume>34</volume><issue>12</issue><spage>2563</spage><epage>2569</epage><pages>2563-2569</pages><issn>0931-041X</issn><eissn>1432-198X</eissn><abstract>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
2
) from the Chronic Kidney Disease in Children (CKiD) study. Based on adult models, the CKiD fragility model included four indicators: (1) suboptimal growth/weight gain (BMI < 5th percentile-for-height-age, deceleration ≥ 10 BMI-for-height-age percentiles/1 year, height-for-age percentile < 3rd or deceleration ≥ 10 height percentiles/1 year); (2) low muscle mass (mid-upper-arm circumference < 5th percentile or deceleration ≥ 10 percentiles/1 year); (3) fatigue (parent/child report); (4) inflammation (CRP > 3 mg/l). Logistic regression was used to evaluate association of fragility indicators with three adverse outcomes: frequent infection (> 1 per year/3 years), hospitalization (any), and rapid CKD progression (decline in eGFR > 30% or initiation of renal replacement therapy within 3 years).
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.</abstract><cop>Berlin/Heidelberg</cop><pub>Springer Berlin Heidelberg</pub><pmid>31375914</pmid><doi>10.1007/s00467-019-04313-8</doi><tpages>7</tpages><orcidid>https://orcid.org/0000-0003-0795-3210</orcidid><oa>free_for_read</oa></addata></record> |
| fulltext | fulltext |
| identifier | ISSN: 0931-041X |
| ispartof | Pediatric nephrology (Berlin, West), 2019-12, Vol.34 (12), p.2563-2569 |
| issn | 0931-041X 1432-198X |
| language | eng |
| recordid | cdi_pubmedcentral_primary_oai_pubmedcentral_nih_gov_6819247 |
| source | SpringerLink Journals - AutoHoldings |
| subjects | Age Arm Arm circumference Children Chronic kidney failure Development and progression Diseases Distribution Epidermal growth factor receptors Fatigue Frailty Genotype & phenotype Hospitalization Infections Inflammation Kidney diseases Medicine Medicine & Public Health Nephrology Original Article Patient outcomes Pediatrics Phenotypes Urology What’s New in Chronic Kidney Disease |
| title | Prevalence and outcomes of fragility: a frailty-inflammation phenotype in children with chronic kidney disease |
| url | https://sfx.bib-bvb.de/sfx_tum?ctx_ver=Z39.88-2004&ctx_enc=info:ofi/enc:UTF-8&ctx_tim=2025-01-07T18%3A58%3A00IST&url_ver=Z39.88-2004&url_ctx_fmt=infofi/fmt:kev:mtx:ctx&rfr_id=info:sid/primo.exlibrisgroup.com:primo3-Article-gale_pubme&rft_val_fmt=info:ofi/fmt:kev:mtx:journal&rft.genre=article&rft.atitle=Prevalence%20and%20outcomes%20of%20fragility:%20a%20frailty-inflammation%20phenotype%20in%20children%20with%20chronic%20kidney%20disease&rft.jtitle=Pediatric%20nephrology%20(Berlin,%20West)&rft.au=Sgambat,%20Kristen&rft.date=2019-12-01&rft.volume=34&rft.issue=12&rft.spage=2563&rft.epage=2569&rft.pages=2563-2569&rft.issn=0931-041X&rft.eissn=1432-198X&rft_id=info:doi/10.1007/s00467-019-04313-8&rft_dat=%3Cgale_pubme%3EA607985136%3C/gale_pubme%3E%3Curl%3E%3C/url%3E&disable_directlink=true&sfx.directlink=off&sfx.report_link=0&rft_id=info:oai/&rft_pqid=2267997967&rft_id=info:pmid/31375914&rft_galeid=A607985136&rfr_iscdi=true |