ArticleAging2020
Frailty modifies the association between opioid use and mortality in chronic kidney disease patients with diabetes: a population-based cohort study.
Article in Aging, 2020. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 12 papers.
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Who cites it
12 citing papers in PubMed, 19 citations in OpenAlex.
- A hierarchical clinical fusion transformer model for personalized opioid treatment: Development and validation in diabetic surgical patients.medRxiv : the preprint server for health sciences · 2026Article
- Sarcopenia, sarcopenic obesity, and frailty in individuals with chronic kidney disease: a comprehensive review.Kidney research and clinical practice · 2026Article
- Exploring optimal analgesic strategies for chronic limb-threatening ischaemia: a systematic review protocol.BMJ open · 2025Article
- Frailty Assessment Tools in Chronic Kidney Disease: A Systematic Review and Meta-analysis.Kidney medicine · 2025Article
- Article
- Literacy for Frailty among Undergraduate Medical Education: An Under-Recognized Opportunity to Improve Geriatric Care.Aging and disease · 2024Article
- The Impact of Glucose-Lowering Strategy on the Risk of Increasing Frailty Severity among 49,519 Patients with Diabetes Mellitus: A Longitudinal Cohort Study.Aging and disease · 2023Article
- Vascular frailty, a proposal for new frailty type: A narrative review.The Kaohsiung journal of medical sciences · 2023Review
- Uremic Toxins and Frailty in Patients with Chronic Kidney Disease: A Molecular Insight.International journal of molecular sciences · 2021Review
- Frailty increases the risk for developing urinary tract infection among 79,887 patients with diabetic mellitus and chronic kidney disease.BMC geriatrics · 2021Article
- The risk trajectory of different cardiovascular morbidities associated with chronic kidney disease among patients with newly diagnosed diabetes mellitus: a propensity score-matched cohort analysis.Cardiovascular diabetology · 2021Article
- Muscle relaxant use and the associated risk of incident frailty in patients with diabetic kidney disease: a longitudinal cohort study.Therapeutic advances in drug safety · 2021Article
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Authors and funding
5 authors at 2 institutions in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
The prevalence of chronic pain in patients with chronic kidney disease (CKD) and diabetes mellitus is high and correlates with higher frailty risk, but satisfactory pain control frequently fails, necessitating opioid initiation. We aimed to examine whether opioid use affected their outcomes and whether such a relationship was modified by frailty. From the longitudinal cohort of diabetes patients (n = 840,000), we identified opioid users with CKD (n = 26,029) and propensity score-matched them to opioid-naïve patients in a 1:1 ratio. We analyzed the associations between opioid use and long-term mortality according to baseline frailty status, defined by the modified FRAIL scale. Among all, 20.3% did not have any FRAIL items, while 57.2%, 20.6%, and 1.9% had 1, 2, and at least 3 positive FRAIL items, respectively. After 4.2 years, 16.4% died. Cox proportional hazard regression showed that opioid users exhibited an 18% higher mortality risk (HR 1.183, 95% CI 1.13-1.24) with a dose- and duration-responsive relationship, compared to opioid-naive ones. Furthermore, the mortality risk posed by opioids was observed only in CKD patients without frailty but not in those with frailty. In conclusion, opioid use increased mortality among patients with CKD, while this negative outcome influence was not observed among frail ones.
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