Frailty and associated factors among older patients with non-dialysis chronic kidney disease: a multicenter cross-sectional study in three hospitals in Yaounde, Cameroon

Abstract

Introduction: frailty is common in older patients with chronic kidney disease (CKD) and is associated with poor quality of life and adverse clinical outcomes. This study aimed to determine the prevalence of frailty among older patients with non-dialysis CKD (ND-CKD) and to determine associated factors in Cameroon. Methods: this cross-sectional study was conducted in three hospitals in Cameroon, including patients with ND-CKD aged ≥60 years. The 2009 CKD Epidemiology Collaboration (CKD-EPI) equation was used to estimate the glomerular filtration rate (eGFR). Frailty was assessed using Fried´s criteria. A multivariate regression analysis was performed, and a p-value ≤0.05 was statistically significant. Results: we included 102 participants (60.8% male) with a median age (interquartile range (IQR)) of 69 (65-73) years. The prevalence of frailty was 35.3%. Compared to patients without frailty, frail patients were older, had lower education, had lower incomes, had a lower eGFR and a lower body mass index (BMI), had a previous stroke, a previous fracture, activities of daily living (ADLs) dependency, had lower muscle strength, and a slower gait speed. Patients with previous stroke (adjusted odds ratio (aOR) 3.9, 95%CI (95% confidence interval) 1.1-13.9) and ADL dependency (aOR 28.2, 95%CI 3.3-235.2) were likely to be frail. Frailty was less frequent in patients with an income-producing activity (aOR 0.05, 95%CI 0.01-0.67). Conclusion: frailty was common in this group of older patients with ND-CKD from Cameroon. Further actions are needed to increase the screening of patients at risk of frailty to tailor interventions, taking into account available resources.