Correlation of Vascular Calcification With Frailty and Quality of Life in Chronic Kidney Disease Stage 4 and 5 Non-dialysis Patients.

AIM

Vascular calcification (VC) is known to be associated with higher cardiovascular risk in chronic kidney disease (CKD). However, its impact on morbidity factors like frailty and quality of life is understudied. This study aims to address this gap by assessing the correlation of VC with frailty and quality of life.

METHODS

Consecutive patients with CKD stage 4 and 5, not on dialysis, were enrolled over one year. Pregnant patients and renal transplant recipients were excluded. VC was assessed using lateral abdominal radiographs, echocardiography, and cardiac computed tomography scans. Frailty was assessed using the Fried frailty phenotype. A Kidney Disease Quality of Life-36 (KDQoL-36) questionnaire was used for quality-of-life assessment which included physical, mental, and kidney disease-related components. We then investigated the relationships between VC, laboratory parameters, quality of life, and frailty.

RESULTS

A total of 202 patients were enrolled, of which, 26% of patients had detectable VC. Older age, smoking, and coronary artery disease were associated with higher prevalence of VC. Stage of CKD or mineral bone disease markers did not show any significant difference between patients with and without VC. Individuals with VC were significantly more likely to be frail than those without (57.4% vs 30.4%, p-value- 0.001). Patients with VC had significantly lower quality of life scores as compared to those without VC (physical component scores - 45.84±18.98 vs 62.34±22.06; mental component scores - 51.18±20.17 vs 65.99±23.75; kidney disease component scores - 64.90±13.65 vs 74.28±16.32, p-value <0.001).

CONCLUSION

Patients with VC showed higher prevalence of frailty and significantly impaired quality of life. This highlights the profound clinical implications of VC on functional decline in CKD patients.