Frailty transitions and risk of chronic kidney disease: insights from the China Health and Retirement Longitudinal Study

Background Frailty is increasingly recognized as a critical factor in the risk of chronic kidney disease (CKD), and it is also a condition that can undergo transitions. However, the relationship between frailty transitions and CKD risk in aging populations remains underexplored. This study aims to i...

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Main Authors: Xiaotong Sun, Che Wang, Rujie Zheng, Zhihao Liu, Wenjuan Song, Xiaoyu Du, Chunlei Liu, Chengzhi Lu
Format: Article
Language:English
Published: Taylor & Francis Group 2025-12-01
Series:Renal Failure
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Online Access:https://www.tandfonline.com/doi/10.1080/0886022X.2025.2478483
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author Xiaotong Sun
Che Wang
Rujie Zheng
Zhihao Liu
Wenjuan Song
Xiaoyu Du
Chunlei Liu
Chengzhi Lu
author_facet Xiaotong Sun
Che Wang
Rujie Zheng
Zhihao Liu
Wenjuan Song
Xiaoyu Du
Chunlei Liu
Chengzhi Lu
author_sort Xiaotong Sun
collection DOAJ
description Background Frailty is increasingly recognized as a critical factor in the risk of chronic kidney disease (CKD), and it is also a condition that can undergo transitions. However, the relationship between frailty transitions and CKD risk in aging populations remains underexplored. This study aims to investigate the association between frailty transitions and CKD risk in middle-aged and older adults using data from the China Health and Retirement Longitudinal Study.Methods Frailty was assessed using a 40-item Frailty Index (FI), with participants categorized into three groups: robust (FI ≤ 0.10), pre-frail (0.10 < FI ≤ 0.21), and frail (FI > 0.21). Frailty transitions were tracked between the first and second waves of the study. Data on CKD incidence were obtained from self-reported physician-diagnosed kidney disease. Cox proportional hazards models were employed to evaluate the risk of CKD, with adjustments made for potential confounders.Results Among 12,050 participants (52.60% female, mean age 58.37), those who progressed to frailty or pre-frailty had an increased risk of CKD compared with stable participants (HR 1.74, p < 0.001). In contrast, individuals who recovered from frailty to robust or pre-frail status had a reduced CKD risk (HR 0.71, p = 0.023). The results of the sensitivity analysis, which showed consistent findings, support the reliability of the results.Conclusion Frailty transitions are significantly associated with the risk of CKD. Worsening frailty is linked to an increased risk of CKD, while improvement in frailty is associated with a lower risk of CKD.
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spelling doaj-art-2207108d284f41d08b16fdbbbfeb5cb62025-08-20T03:41:57ZengTaylor & Francis GroupRenal Failure0886-022X1525-60492025-12-0147110.1080/0886022X.2025.2478483Frailty transitions and risk of chronic kidney disease: insights from the China Health and Retirement Longitudinal StudyXiaotong Sun0Che Wang1Rujie Zheng2Zhihao Liu3Wenjuan Song4Xiaoyu Du5Chunlei Liu6Chengzhi Lu7The First Central Clinical School, Tianjin Medical University, Tianjin, ChinaSchool of Medicine, Nankai University, Tianjin, ChinaThe First Central Clinical School, Tianjin Medical University, Tianjin, ChinaSchool of Medicine, Nankai University, Tianjin, ChinaThe First Central Clinical School, Tianjin Medical University, Tianjin, ChinaThe First Central Clinical School, Tianjin Medical University, Tianjin, ChinaSchool of Medicine, Nankai University, Tianjin, ChinaDepartment of Cardiology, Tianjin First Central Hospital, Tianjin, ChinaBackground Frailty is increasingly recognized as a critical factor in the risk of chronic kidney disease (CKD), and it is also a condition that can undergo transitions. However, the relationship between frailty transitions and CKD risk in aging populations remains underexplored. This study aims to investigate the association between frailty transitions and CKD risk in middle-aged and older adults using data from the China Health and Retirement Longitudinal Study.Methods Frailty was assessed using a 40-item Frailty Index (FI), with participants categorized into three groups: robust (FI ≤ 0.10), pre-frail (0.10 < FI ≤ 0.21), and frail (FI > 0.21). Frailty transitions were tracked between the first and second waves of the study. Data on CKD incidence were obtained from self-reported physician-diagnosed kidney disease. Cox proportional hazards models were employed to evaluate the risk of CKD, with adjustments made for potential confounders.Results Among 12,050 participants (52.60% female, mean age 58.37), those who progressed to frailty or pre-frailty had an increased risk of CKD compared with stable participants (HR 1.74, p < 0.001). In contrast, individuals who recovered from frailty to robust or pre-frail status had a reduced CKD risk (HR 0.71, p = 0.023). The results of the sensitivity analysis, which showed consistent findings, support the reliability of the results.Conclusion Frailty transitions are significantly associated with the risk of CKD. Worsening frailty is linked to an increased risk of CKD, while improvement in frailty is associated with a lower risk of CKD.https://www.tandfonline.com/doi/10.1080/0886022X.2025.2478483Frailty transitionschronic kidney diseaseCHARLSaging population
spellingShingle Xiaotong Sun
Che Wang
Rujie Zheng
Zhihao Liu
Wenjuan Song
Xiaoyu Du
Chunlei Liu
Chengzhi Lu
Frailty transitions and risk of chronic kidney disease: insights from the China Health and Retirement Longitudinal Study
Renal Failure
Frailty transitions
chronic kidney disease
CHARLS
aging population
title Frailty transitions and risk of chronic kidney disease: insights from the China Health and Retirement Longitudinal Study
title_full Frailty transitions and risk of chronic kidney disease: insights from the China Health and Retirement Longitudinal Study
title_fullStr Frailty transitions and risk of chronic kidney disease: insights from the China Health and Retirement Longitudinal Study
title_full_unstemmed Frailty transitions and risk of chronic kidney disease: insights from the China Health and Retirement Longitudinal Study
title_short Frailty transitions and risk of chronic kidney disease: insights from the China Health and Retirement Longitudinal Study
title_sort frailty transitions and risk of chronic kidney disease insights from the china health and retirement longitudinal study
topic Frailty transitions
chronic kidney disease
CHARLS
aging population
url https://www.tandfonline.com/doi/10.1080/0886022X.2025.2478483
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