RT Journal Article
T1 Assessment of frailty in patients with advanced chronic kidney disease, and the role of microvesicles: A single-center study
A1 Gimena Muñoz, Rocío
A1 Valera Arévalo, Gemma
A1 Rodríguez San Pedro, María del Mar
A1 Pérez Fernández, María
A1 Arévalo Serrano, Juan
A1 S. Waikar, Sushrut
A1 Ramírez Chamond, Rafael
A1 Rodríguez Puyol, Diego
A1 Carracedo Añón, Julia María
A1 Martínez Miguel, Patricia
AB BackgroundFrailty is a highly prevalent syndrome in patients with advanced age and chronic diseases, and it is associated with atherothrombotic pathologies, suggesting a procoagulant state in these patients. Circulating microvesicles (cMVs), are small phospholipid-rich vesicles, which have been shown to participate in atherothrombotic onset and progression. We aim to analyze frailty in patients with advanced chronic kidney disease (CKD), and to determine the role of microvesicles in this population.Materials and methodsWe conducted a prospective cohort study with 85 patients with advanced CKD. Our main objective was to evaluate frailty and its novel association with circulating microvesicles in advanced CKD. To define frailty, Fried’s five criteria were used and we obtained blood for cMVs analysis by flow cytometry.ResultsThe prevalence of frailty in patients with advanced CKD was 27% (CI 95% 17-37%). We found that risk factors for frailty were age (OR 1.06; CI 95% to 1.11; p=0.027), type 2 diabetes mellitus (OR 5.77; CI 95% to 18.9; p=0.004) and hemoglobin (g/dL) (OR 0.63; CI 95% to 0.94; p=0.023). Total cMVs, platelet derived cMVs and endothelial derived cMVs were significantly higher in frail patients. In the predictive multivariable binary logistic regression model over frailty, three predictors explain 41% of the variability of frailty (Nagelkerke square R = 0.41; p <0.001) with the following contribution: T2DM (19%), total cMVs (14%) and hemoglobin (8%).DiscussionFrailty is highly prevalent in patients with advanced CKD. Although we still do not know in depth the mechanisms involved in frailty, to our knowledge this is the first study that links cMVs and frailty in patients with advanced CKD. In our opinion it could be explored as a good biomarker or therapeutic target in advanced CKD.
PB Public Library of Science
YR 2025
FD 2025-09
LK https://hdl.handle.net/20.500.14352/125277
UL https://hdl.handle.net/20.500.14352/125277
LA eng
NO Gimena Muñoz R, Valera Arévalo G, Rodríguez San Pedro MdM, Pérez Fernández M, Arévalo Serrano J, S. Waikar S, et al. (2025) Assessment of frailty in patients with advanced chronic kidney disease, and the role of microvesicles: A single-center study. PLoS One 20(9): e0332653. https://doi.org/10.1371/journal.pone.0332653
DS Docta Complutense
RD 27 mar 2026