Systemic inflammation is associated with reduced functional recovery in older inpatients with chronic kidney disease

Abstract

Purpose: To investigate the association between systemic inflammation and activities of daily living (ADL) in older patients with chronic kidney disease (CKD) in the acute phase.

Methods: This observational, retrospective cohort study included patients with CKD aged 65 years and older with unscheduled admissions to the nephrology department between January 2019 and February 2022. Patients who underwent maintenance hemodialysis therapy; died during hospitalization; were treated in other departments; experienced serious events during hospitalization; or did not receive rehabilitation during hospitalization were excluded. Systemic inflammation was assessed by the modified Glasgow Prognostic Score (mGPS) on admission, and ADL was assessed by functional independence measure (FIM) at discharge.

Results: A total of 89 patients (median age, 80 years [interquartile range, 75-84 years]) were included in the analysis. An mGPS score of 0, 1, and 2 was assigned to 41 (46.1%), 15 (16.9%), and 33 (37.1%) patients, respectively. In multivariable analysis, the mGPS (SE = 2.16; β = - 0.25; P = 0.001) was significantly associated with the FIM score at discharge. On the other hand, albumin (ρ = 0.093; 95% CI, - 0.12 to 0.30; P = 0.384) and CRP level (ρ = - 0.176; 95% CI; - 0.37 to 0.03; P = 0.098) were not significantly correlated with the FIM score at discharge.

Conclusion: Among older patients with CKD in the acute phase, systemic inflammation assessed using the mGPS may be useful for predicting ADL.

Keywords: Activities of daily living; Chronic kidney disease; Functional independence measure; Modified glasgow prognostic score; Systemic inflammation.