Kidney Tubular Injury and Dysfunction Relate to Frailty and Cognitive Function in Persons with CKD in SPRINT
Bibliographic record
Abstract
Background: The association of markers of kidney disease (eGFR and albuminuria) with frailty and cognition is well established. However, these markers do not specifically evaluate kidney tubule injury or dysfunction. Methods: We measured 8 biomarkers of kidney tubule dysfunction and injury among 2,282 SPRINT participants with eGFR < 60 and evaluated their associations with frailty and cognitive function. Frailty was defined with a previously validated frailty index (FI), categorized as fit (FI < 0.10), less fit (0.10 < FI < 0.21), and frail (FI > 0.21). Global cognitive function was measured using the Montreal Cognitive Assessment (MoCA). Models were adjusted for, demographic, behavioral, and clinical variables including urine creatinine, eGFR and albuminuria. Results: Higher urine concentrations of MCP-1 & α1M were independently associated with frailty (Figure). These associations were independent of demographics, other CKD risk factors, eGFR and albuminuria, and were comparatively stronger than associations of albuminuria with frailty (Figure). Higher urine β2M was associated with lower cognitive function (β: -0.09; 95% CI -0.17, -0.01), whereas albuminuria was not (β: -0.03; 95% CI -0.13, 0.08). Conclusions: Urine markers of tubulointerstitial fibrosis (captured by MCP-1) and diminished proximal tubule reabsorptive capacity (captured by α1M and β2M) were associated with frailty and worse cognition independent of eGFR and albuminuria in hypertensive trial participants with CKD. Funding: NIDDK Support, Other NIH Support - NIA, NINDS, NHLBI, Veterans Affairs SupportFigure. Multinomial regression showing the baseline association between biomarkers of kidney tubule dysfunction and injury with frailty compared with fit older adults (less fit group omitted). Models were adjusted for age, sex, race, BMI, alcohol use, years of education, SBP and DBP, smoking status, urine creatinine, eGFR, and albuminuria.
Fetched live from OpenAlex and de-inverted. Abstracts are not stored in this database: the inverted indexes are 8.6 GB of the frame’s 9.3 GB of text, and the host has 13 GB free.
How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.001 | 0.002 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.000 | 0.001 |
| Bibliometrics | 0.001 | 0.001 |
| Science and technology studies | 0.000 | 0.000 |
| Scholarly communication | 0.001 | 0.000 |
| Open science | 0.000 | 0.001 |
| Research integrity | 0.000 | 0.001 |
| Insufficient payload (model declined to judge) | 0.001 | 0.000 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".