Kidney Week

Abstract: FR-PO921

Step Length as a Novel Predictor of Physical Function in Patients with CKD

Session Information

• Geriatric Nephrology
  November 03, 2017 | Location: Hall H, Morial Convention Center
  Abstract Time: 10:00 AM - 10:00 AM

Category: Geriatric Nephrology

• 901 Geriatric Nephrology

Authors

• Pai, Rima N., Albert Einstein College of Medicine, New York, New York, United States

Rima N. Pai,

• Buttar, Rupinder singh, Jacobi medical center, Bronx, New York, United States

Rupinder singh Buttar,

• Paredes, William, Albert Einstein College of Medicine , Bronx, New York, United States

William Paredes,

• Custodio, Matthew, Albert Einstein College of Medicine, New York, New York, United States

Matthew Custodio,

• Farooq, Hina, Louis A. Weiss Memorial Hospital, Chicago, Illinois, United States

Hina Farooq,

• ZAIDI, BUSHRA, ALBERT EINSTEIN COLLEGE OF MEDICINE, Bronx, New York, United States

BUSHRA ZAIDI,

• Karki, Nabin Raj, Medstar Harbor Hospital, Baltimore, Maryland, United States

Nabin Raj Karki,

• Sharma khatiwada, Aagat, University of Leicester, Leicester, United Kingdom

Aagat Sharma khatiwada,

• Ansah-Addo, Stephen, Albert Einstein College of Medicine, New York, New York, United States

Stephen Ansah-Addo,

• Tran, Ashley, Ambra Health, Holmdel, New Jersey, United States

Ashley Tran,

• Hawkins, Meredith, Albert Einstein College of Medicine, New York, New York, United States

Meredith Hawkins,

• Abramowitz, Matthew K., Albert Einstein College of Medicine, New York, New York, United States

Matthew K. Abramowitz,

Background

Impaired mobility and disability are common in patients with CKD and contribute to morbidity and mortality. Novel predictors of functional decline could facilitate earlier identification of at-risk patients.

Methods

We measured average step length (SL) in 32 patients with CKD stages 4 and 5 who had physical function assessments performed every 3 months (median, 4 assessments). SL was calculated based on the number of steps needed to complete a 4m walk at usual pace. We also assessed lower extremity performance (Short Physical Performance Battery), muscle strength, endurance capacity (2 minute walk distance), self-reported physical function (SF-36 Physical Component Score (PCS)), and symptom burden (Renal Palliative Care Outcome Scale (POS)). Age and sex-adjusted linear regression and mixed effects models were used to test the association of SL with baseline characteristics and with physical function parameters over time, respectively.

Results

The mean age was 64±13 years, 44% were women, mean eGFR 20±10 mL/min/1.73m², mean BMI 32±7 kg/m², 59% had diabetes, and 16% had peripheral vascular disease. Lower PCS and higher POS associated with shorter SL (4.7cm (1.8-7.7) and 6.3cm (2.7-9.9) per 10 point difference, respectively), as did 2 SPPB domains (2.3cm (1.7-2.9) per 0.1m/s slower gait speed and 7.3cm (1.1-13.5) shorter SL with impaired balance). Over time, each 10cm shorter SL was associated with 1.4kg (0.2-2.7) weaker handgrip strength and 26.5ft (8.6-44.5) shorter 2-minute walk distance, and with 0.4 point (0.02-0.7) decrease in SPPB during follow-up. Furthermore, SL was shorter in patients experiencing a fall (46±11 vs. 56±8 cm, p=0.008).

Conclusion

In a cohort of patients with advanced CKD, shorter SL associated with poorer subjective and objective measures of physical function and with the likelihood of falling. SL may be a useful predictor of fall risk and functional decline in CKD patients.

Funding

• NIDDK Support