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Volume 16
Issue 1
10.3390/life16010045
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This is an early access version, the complete PDF, HTML, and XML versions will be available soon.
Article

Interaction Between Frailty and Renal Function in Patients with Heart Failure

by
Ángela Rodríguez-Eguren
1,
José Jesús Broseta
2,3,4,5,
Lydia Izquierdo
1,
Joan Llevadot-Sesmilo
1,
Eduard Solé Gonzalez
1,2,
María Ángeles Castel
1,2,6,
Juan José Rodriguez
1,2,
Elena Cuadrado-Payán
2,3,4,
Diana Rodriguez-Espinosa
2,3,4,
Elena Sandoval
2,7,
Aleix Cases
2,3,
Francisco Maduell
2,3,4,5,
Ana García-Álvarez
1,2,5,6,8,
Marta Farrero
1,2,5 and
Pedro Caravaca-Pérez
1,2,*
1
Heart Failure and Heart Transplant Unit, Institut Clínic Cardiovascular (ICCV), Hospital Clínic, Universitat de Barcelona, 08007 Barcelona, Spain
2
Institut d’Investigacions Biomèdiques August Pi I Sunyer (IDIBAPS), 08036 Barcelona, Spain
3
Nephrology and Renal Transplantation, Hospital Clínic de Barcelona, 08036 Barcelona, Spain
4
Laboratori Experimental de Nefrologia i Trasplantament (LENIT), 08036 Barcelona, Spain
5
Department of Medicine, Universitat de Barcelona, 08007 Barcelona, Spain
6
Centro de Investigación Biomédica en Red, Enfermedades Cardiovasculares (CIBERCV), 28029 Madrid, Spain
7
Cardiovascular Surgery Department, Hospital Clinic de Barcelona, 08036 Barcelona, Spain
8
Centro Nacional de Investigaciones Cardiovasculares (CNIC), 28029 Madrid, Spain
*
Author to whom correspondence should be addressed.
Life 2026, 16(1), 45; https://doi.org/10.3390/life16010045 (registering DOI)
Submission received: 15 November 2025 / Revised: 24 December 2025 / Accepted: 25 December 2025 / Published: 26 December 2025
(This article belongs to the Special Issue Cardiorenal Disease: Pathogenesis, Diagnosis, and Treatments)
Review Reports Versions Notes

Abstract

Background. Frailty is highly prevalent among patients with heart failure (HF) and is associated with adverse clinical outcomes. Chronic kidney disease (CKD) frequently coexists with HF and may further increase risk. However, the clinical profile linking frailty and CKD remains insufficiently characterized. This study aimed to determine the prevalence and clinical correlates of frailty in outpatients with HF and to assess whether its prognostic significance varies across CKD severity. Methods. A prospective, observational cohort of HF outpatients was enrolled. Frailty was defined according to Fried’s phenotype (≥3 criteria). Factors associated with frailty were identified using logistic regression. The primary endpoint was a composite of all-cause mortality or HF hospitalization over one year. Cox proportional hazards models were used to evaluate associations between frailty and outcomes and to test its interaction with CKD. Results. A total of 459 HF outpatients (median age 75 [IQR 68–82] years; 72% men) were included. Frailty was present in 39.9% of patients and increased progressively with worsening renal function—from 14% in those with eGFR >60 to 38% in eGFR 30–60 and 48% in eGFR <30 mL/min/1.73 m2 (p < 0.001). In multivariate analysis, older age, prior stroke, higher CA125 levels, and lower eGFR were independently associated with frailty. Frail patients had a higher risk of all-cause death or HF hospitalization (adjusted HR 2.09; 95% CI 1.22–3.58; p = 0.007), with an amplified effect among those with advanced CKD (HR 5.02; 95% CI 2.46–10.22; p < 0.001). Conclusions. In HF outpatients, frailty is common and closely linked to renal dysfunction. Its coexistence with advanced CKD identifies a subgroup at the highest risk of adverse outcomes. Combined assessment of frailty and renal function may enhance prognostic precision and guide more individualized therapeutic strategies.
Keywords: heart failure; chronic kidney disease; frailty heart failure; chronic kidney disease; frailty

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MDPI and ACS Style

Rodríguez-Eguren, Á.; Broseta, J.J.; Izquierdo, L.; Llevadot-Sesmilo, J.; Solé Gonzalez, E.; Castel, M.Á.; Rodriguez, J.J.; Cuadrado-Payán, E.; Rodriguez-Espinosa, D.; Sandoval, E.; et al. Interaction Between Frailty and Renal Function in Patients with Heart Failure. Life 2026, 16, 45. https://doi.org/10.3390/life16010045

AMA Style

Rodríguez-Eguren Á, Broseta JJ, Izquierdo L, Llevadot-Sesmilo J, Solé Gonzalez E, Castel MÁ, Rodriguez JJ, Cuadrado-Payán E, Rodriguez-Espinosa D, Sandoval E, et al. Interaction Between Frailty and Renal Function in Patients with Heart Failure. Life. 2026; 16(1):45. https://doi.org/10.3390/life16010045

Chicago/Turabian Style

Rodríguez-Eguren, Ángela, José Jesús Broseta, Lydia Izquierdo, Joan Llevadot-Sesmilo, Eduard Solé Gonzalez, María Ángeles Castel, Juan José Rodriguez, Elena Cuadrado-Payán, Diana Rodriguez-Espinosa, Elena Sandoval, and et al. 2026. "Interaction Between Frailty and Renal Function in Patients with Heart Failure" Life 16, no. 1: 45. https://doi.org/10.3390/life16010045

APA Style

Rodríguez-Eguren, Á., Broseta, J. J., Izquierdo, L., Llevadot-Sesmilo, J., Solé Gonzalez, E., Castel, M. Á., Rodriguez, J. J., Cuadrado-Payán, E., Rodriguez-Espinosa, D., Sandoval, E., Cases, A., Maduell, F., García-Álvarez, A., Farrero, M., & Caravaca-Pérez, P. (2026). Interaction Between Frailty and Renal Function in Patients with Heart Failure. Life, 16(1), 45. https://doi.org/10.3390/life16010045

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