Impact of aging on alanine aminotransferase and frailty among chronic kidney disease patients: Laboratory-based cross-sectional study in Northwest Ethiopia

Melaku Mekonnen Agidew ^1* Anemut Tilahun Mulu ¹ Awgichew Behaile Teklemariam ¹ Misganaw Asmamaw Mengstie ¹ Addisu Melake ¹ Edgeit Abebe Zewde ² Zelalem Tilahun Muche ² Samuel Berihun Dagnew ³ Nega Dagnew Baye ⁴ Bezawit Adane ⁵ Muluken Walle ⁶ Girma Derso ⁷

• ¹ Department of Biochemistry, College of Health Sciences, Debre Tabor University, Debre Tabor, Amhara, Ethiopia
• ² Department of Physiology, College of Health Science, Debre Tabor University, Debre Tabor, Amhara, Ethiopia
• ³ Department of Pharmacy, College of Health Sciences, Debre Tabor University, Debre Tabor, Ethiopia
• ⁴ Department of Human Anatomy, College of Medicine and Health Sciences, University of Gondar, Gondar, Amhara Region, Ethiopia
• ⁵ Department of Epidemiology and Biostatistics, School of Public Health, College of Health Sciences, Injibara University, Injibara, Ethiopia
• ⁶ School of Biomedical and Laboratory Sciences, College of Medicine and Health Sciences, University of Gondar, Gondar, Amhara Region, Ethiopia
• ⁷ Amhara Regional Health Bureau, Bahir Dar, Amhara Region, Ethiopia

Background: Chronic kidney disease (CKD) is non-communicable progressive failure in kidney functions leading to different complications. Serum alanine aminotransferase (ALT) is important diagnosing biomarker for liver comorbidities. However, ALT in CKD patients could be affected by aging. Despite this challenge, there is scarcity of data on the effect of aging on frailty and level of ALT among CKD patients in Ethiopia. Thus, this study aimed to assess the impact of aging on serum level of ALT and magnitude of frailty and associated factors among CKD patients with different age groups.Method: Hospital-based cross-sectional study involving 120 CKD patients was conducted in Bahir Dar, Ethiopia. Data were collected using structured questionnaire. Blood pressure, anthropometric parameters, ALT, and frailty were assessed based on standard procedures. Data was analyzed using SPSS version 25. Pearson's correlation analysis, multiple linear, and logistic regression analysis were applied to identify predictors of ALT and frailty, with statistical significance set at p < 0.05.The serum level of ALT was significantly lower in CKD patients in (≥ 46 years) compared to CKD patients in (18-45) years of age. The magnitude of frailty among CKD patients in (18-45 years) and (≥ 46 years), respectively were 8.5% (95% CI: 1.4-15.6) and 34.4% (95% CI: 22.5-46.4) and significantly associated with ALT. Age category (AOR: 0.16, 95% CI: 0.04-0.60) and hypertension (HTN) (AOR: 10.16, 95% CI: 1.03-99.90) were factors significantly associated with frailty.The serum level of ALT was significantly correlated with age and frailty in CKD patients. Thus, ALT can be considered as useful biomarker of aging and frailty. The age of CKD patients and HTN were factors significantly associated with frailty.