Bayesian analysis of frailty risk factors in chronic kidney disease : a nationwide cross-sectional survey

Abstract

Introduction: Frailty in chronic kidney disease (CKD) patients is associated with increased risk of adverse health outcomes. Understanding the contributing factors to frailty in this population is crucial for developing targeted interventions and improving patient care. The objective of this study is to identify and quantify potential risk factors associated with frailty in chronic kidney disease patients. Methods: We conducted a cross-sectional study using data from the China Health and Retirement Longitudinal Study (CHARLS) cohorts of 2011 and 2015. A Bayesian mixed-effects logistic regression model was utilized to analyze the relationship between selected features and frailty in chronic kidney disease. Results: Of 1,924 participants, about one-third (n = 634) were classified as frail. Depression emerged as the strongest predictor of frailty (adjusted OR 289.49, 95%CrI 47.24–2284.82). Other significant factors included stroke (adjusted OR 18.04, 95%CrI 1.94–183.99), chronic lung disease (adjusted OR 7.96, 95%CrI 1.84–39.44), and rheumatism (adjusted OR 3.84, 95%CrI 1.12–15.14). Poor vision (adjusted OR 5.84, 95% CrI 1.68–25.25) and poor sleep quality (adjusted OR 5.12, 95% CrI 1.53–21.13), though the latter showed some instability after data imputation, were also associated with higher frailty risk. Elevated cystatin C levels showed a strong positive association (adjusted OR 52.46, 95%CrI 9.51–356.12), while higher creatinine levels were associated with lower frailty risk (adjusted OR 0.24, 95%CrI 0.07–0.81). Conclusion: This study identified several potential contributing factors to frailty in CKD patients, with depression emerging as the strongest predictor. The counterintuitive relationship between creatinine levels and frailty underscores the complex interplay between muscle mass/quality and kidney function in frailty development, warranting further investigation.