Abstract
BackgroundChronic kidney disease (CKD) involves many factors that can cause frailty and oral hypofunction. We aimed to investigate the prevalence of frailty and oral hypofunction and to examine the associations among kidney function, frailty, and oral function in adults with CKD in Japan.MethodsThis cross-sectional study was conducted at two institutions. The participants included 109 patients with CKD stages 3–5 who visited outpatient clinics or were admitted for inpatient treatment. Frailty was evaluated using the Japanese version of the Cardiovascular Health Study frailty criteria. Oral function was evaluated by assessing oral motor skills [oral diadochokinesis (ODK) rate], masticatory ability, and the repetitive saliva swallowing test. The estimated glomerular filtration rate (eGFR) was used to indicate kidney function. We examined the associations among kidney function, frailty, and oral function using binomial logistic regression analysis.ResultsIn total, 31 participants (28.4%) were classified as being frail. Univariate analysis showed that age, body mass index, eGFR, and haemoglobin level were significantly associated with frailty. ODK and swallowing function were significantly associated with frailty. Multivariate analysis revealed that frailty was significantly associated with eGFR [odds ratio (OR) 0.96, 95% confidence interval (CI) 0.92–1.00, p = 0.048] and ODK rate (OR 0.68, CI 0.47–0.98, p = 0.038). However, no significant association was found between CKD severity and masticatory or swallowing function.ConclusionWe found a high prevalence of frailty in patients with CKD and a significant association between frailty and oral motor skills, affecting the swallowing function of patients with nondialysis CKD. The high prevalence of frailty among patients with CKD suggests that routine assessment of frailty is necessary to prevent the development of severe complications. In addition, oral and kidney function should be carefully evaluated, and oral health education and interventions should be performed for patients with CKD.
Highlights
Chronic kidney disease (CKD) involves many factors that can cause frailty and oral hypofunction
We aimed to investigate the prevalence of frailty and oral hypofunction relative to CKD severity, as well as to examine the associations among kidney function, frailty, and oral functions in adults with CKD in Japan
Multivariate analysis showed that decreased kidney function and oral motor skills were independent factors associated with frailty, Table 3 Associations among frailty, kidney function, and oral function
Summary
Chronic kidney disease (CKD) involves many factors that can cause frailty and oral hypofunction. We aimed to investigate the prevalence of frailty and oral hypofunction and to examine the associations among kidney function, frailty, and oral function in adults with CKD in Japan. Chronic kidney disease (CKD) is a common disease worldwide [1] and is associated with several comorbid diseases, such as hypertension, chronic cardiovascular disease, hyperuricaemia, and metabolic syndrome [2]. Patients with CKD are more than twice as likely to report reduced physical activity than patients without CKD due to systemic abnormalities caused by worsening kidney function. Patients with CKD often develop sarcopenia due to muscle weakness caused by protein–energy wasting [3]. Frailty is strongly associated with malnutrition, sarcopenia, resting metabolic rate, and decreased energy expenditure [7]. A large, population-based Japanese survey found that 11.3% of elderly participants had symptoms of frailty [8]
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