Abstract: FR-PO912

CKD Measures and Physical Function in Older Adults: The Atherosclerosis Risk in Communities (ARIC) Study

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

  • Shibagaki, Yugo, Division of Nephrology and Hypertension, St Marianna University Hospital, Kawasaki, Japan
  • Ballew, Shoshana, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland, United States
  • Palta, Priya, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, United States
  • Windham, B Gwen, UMMC, Jackson, Mississippi, United States
  • Coresh, Josef, Welch Center for Prevention, Epidemiology & Clinical Research, Baltimore, Maryland, United States
  • Matsushita, Kunihiro, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland, United States
Background

Reduced estimated glomerular filtration rate (eGFR) has been shown to be related to impaired physical function. However, data on the other chronic kidney disease (CKD) measure, albuminuria, in this context are sparse. Furthermore, whether cognitive function modifies these associations is unknown.

Methods

Among 4,608 community-dwelling older adults at ARIC visit 5 (2011-2013), we studied cross-sectional associations of eGFR with cystatin C (eGFRcys) and urine albumin-creatinine ratio (ACR) with physical function based on the Short Physical Performance Battery (SPPB). Cognitive function was classified as no cognitive impairment, mild cognitive impairment (MCI), or dementia according to a diagnostic review of neuropsychiatric, neurologic, and brain imaging assessments.

Results

Mean age of participants was 75.7 (SD 5.1) years, and median SPPB was 10 (IQR 8-11), with 13.8% (n=636) having impaired physical function (defined as SPPB score <6). Adjusted for potential confounders, the odds ratio of having impaired physical function was 1.98 (95%CI 1.21-3.24) in GFR <45 ml/min/1.73m2, 1.42 (0.88-2.30) in GFR 45-59, and 0.98 (0.61-1.57) in GFR 60-89, compared to GFR ≥90 (Table). Similarly, the odds ratio was 1.92 (95%CI 1.20-3.05) in ACR ≥300 mg/g and 1.71 (1.38-2.14) in ACR 30-299, compared to ACR <30. When stratified by cognitive function (n=3,449 with normal and 1,159 with MCI/dementia), of the associations of eGFF and ACR with impaired physical function were stronger in normal cognition than in MCI/dementia (Table).

Conclusion

Both high albuminuria and low eGFR were independently associated with impaired physical function, with more evident results when cognition was preserved.

Adjusted odds ratios (95% CIs) of impaired physical function according to CKD measures.
 eGFRcysUACR
>= 90
N=353
60 – 90
N=1,963
45 – 60
N=1,286
< 45
N=1,006
< 30
N=3,700
30 – 300
N=792
>= 300
N=116
Total
N=4,608
1
(ref)
0.98
(0.61-1.57)
1.42
(0.88-2.30)
1.98
(1.21-3.24)
1
(ref)
1.71
(1.38-2.14)
1.92
(1.20-3.05)
Normal cognition
N=3,450
1
(ref)
1.04
(0.57-1.89)
1.61
(0.88-2.97)
2.17
(1.16-4.05)
1
(ref)
1.91
(1.44-2.52)
2.14
(1.14-4.02)
MCI/Dementia
N=1,158
1
(ref)
0.70
(0.31-1.58)
0.93
(0.41-2.11)
1.33
(0.58-3.06)
1
(ref)
1.39
(0.96-2.00)
1.46
(0.73-2.94)

Adjusted for age, race, gender, education, smoking, alcohol, body mass index, anemia, high sensitive CRP, diabetes, hypertension, history of stroke, history of coronary heart disease, heart failure, and peripheral arterial disease.