Association between frailty and bone health in early-stage chronic kidney disease: a study from the population-based CARTaGENE cohort
Bibliographic record
Abstract
ABSTRACT Background Frailty is a clinical syndrome that is particularly prevalent in patients with chronic kidney disease (CKD). We aimed to assess the associations between renal function and the presence of frailty criteria and to assess the association between frailty and bone outcomes. Methods We have conducted a retrospective study from a population-based cohort, which represents 1% of people aged 40–69 years in a Canadian province, excluding individuals with an estimated glomerular filtration rate (eGFR) <30 mL/min/1.73 m2. Frailty was defined with Fried's criteria. Bone density was estimated with quantitative ultrasound at the calcaneus measuring speed of sound (SOS) and broadband ultrasound attenuation (BUA). Time to first fracture event was assessed and analyses were conducted using logistic regressions, multiple linear regressions and Cox models. Results Overall, 19 973 individuals were included: mean ± standard deviation age 54.2 ± 7.8 years, women 51.6%, 47.0% CKD stage G2, 3.9% CKD stage G3, 34.8% with at least one frailty criterion. We observed a U-shaped association between eGFR and the odds ratio (OR) of presenting at least one frailty criterion, with a minimum OR around 77 mL/min/1.73 m2 [per a 10 mL/min/1.73 m2 increase, respectively, for an eGFR <77 and >77, OR = 0.93, 95% confidence interval (CI) 0.86–1.01 and OR 1.09, 95% CI 1.06–1.13]. After a median follow-up of 5.8 years, there were 837 fracture events. Having at least one frailty criterion was negatively associated with SOS (β = –3.97, P < .0001) and BUA (β = –1.82, P < .0001). Having at least one frailty criterion was associated with a higher fracture risk (hazard ratio 1.23, 95% CI 1.07–1.42). Conclusion In conclusion, having at least one frailty criterion was associated with a higher risk of fracture and a lower bone mineral density.
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How this classification was reachedexpand
Full frame distilled prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. Learned from the 10,348 direct Codex labels and 10,348 direct Gemma labels. Candidate is the union of thresholded teacher heads; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels or direct frontier model labels.
Codex and Gemma teacher scores by category
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.003 | 0.004 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.001 | 0.000 |
| Bibliometrics | 0.000 | 0.000 |
| Science and technology studies | 0.000 | 0.000 |
| Scholarly communication | 0.000 | 0.000 |
| Open science | 0.000 | 0.000 |
| Research integrity | 0.000 | 0.001 |
| Insufficient payload (model declined to judge) | 0.000 | 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 teacher head, 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".