Frailty Is Associated with Malnutrition-Inflammation Syndrome in Older CKD Patients

• Published in: Nutrients 2024-08, Vol.16 (16), p.2626
• Main Authors: Molinari, Paolo, Caldiroli, Lara, Abinti, Matteo, Nardelli, Luca, Armelloni, Silvia, Cesari, Matteo, Castellano, Giuseppe, Vettoretti, Simone
• Format: Article
• Language: English
• Subjects: Aged; Aged, 80 and over; Body mass index; Chemokine CCL2 - blood; chronic kidney disease (CKD); Cross-Sectional Studies; Cytokines; Cytokines - blood; Exercise; Female; Frail Elderly; Frailty; Frailty - blood; Frailty - complications; Geriatric Assessment - methods; Glomerular Filtration Rate; Humans; Immunoassay; Inflammation; Inflammation - blood; Interleukin-6 - blood; Kidney diseases; Male; Malnutrition; Malnutrition - blood; Morbidity; Mortality; Nutritional status; Patients; Proteins; Renal Insufficiency, Chronic - blood; Renal Insufficiency, Chronic - complications; Statistical analysis; Syndrome; systemic inflammation; Toxins
• ISSN: 2072-6643; 2072-6643
• DOI: 10.3390/nu16162626

Patients affected by chronic kidney disease (CKD) are generally considered to be frailer than those with preserved renal function. We cross-sectionally evaluated the associations between frailty, malnutrition-inflammation syndrome and circulating inflammatory cytokines in 115 older individuals with advanced CKD. As for frailty definition, we adopted Fried's frailty phenotype (FP), while malnutrition-inflammation syndrome was assessed using the Malnutrition-Inflammation Score (MIS) and circulating inflammatory cytokines (IL-6; TNFα; MCP-1). A total of 48 patients were frail, and mean eGFR was comparable in both frail and non-frail patients (24 ± 10 vs. 25 ± 11 mL/min/1.73 m ; = 0.63). Frail patients had higher MIS (6 [4-11] vs. 4 [3-5]; < 0.0001) but cytokine concentrations were comparable in both groups. At multivariate regression, FP was independently associated with MIS, age, gender and pre-albumin but not with cytokines. However, we found some associations between inflammatory cytokines and some specific frailty criteria: weight loss and slowness were associated with MCP-1 (respectively = 0.049 and < 0.0001) and weakness with IL-6 ( = 0.005); in conclusion, in older patients with advanced CKD, frailty is strictly associated with malnutrition-inflammation syndrome but not with circulating inflammatory cytokines.