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Kidney Week

Abstract: FR-PO534

Factors Associated with Functional Impairment in Mild to Moderate CKD

Session Information

Category: CKD (Non-Dialysis)

  • 1902 CKD (Non-Dialysis): Clinical, Outcomes, and Trials


  • McIntyre, Natasha Juliette, University of Nottingham, Nottingham, United Kingdom
  • Morris, James E., University of Southampton, Southampton, United Kingdom
  • Fraser, Simon DS, University of Southampton, Southampton, United Kingdom
  • Harris, Scott, University of Southampton, Southampton, United Kingdom
  • Shardlow, Adam, University of Nottingham, Nottingham, United Kingdom
  • Roderick, Paul J., University of Southampton, Southampton, United Kingdom
  • McIntyre, Christopher W., London Health Sciences Centre, London, Ontario, Canada
  • Fluck, Richard J., Royal Derby Hospital, Derby, United Kingdom
  • Taal, Maarten W., University of Nottingham, Nottingham, United Kingdom

Chronic kidney disease (CKD) is associated with functional impairment (reduced physical ability to perform normal activities and independently self-care) and may impact on quality of life. Additional factors related to functional impairment in CKD are less well described and may help identify those needing assessment and intervention. This study explored factors associated with functional impairment in people with mild to moderate CKD and comorbidities.


Data were analysed from 1013 patients at 5y follow up in the Renal Risk in Derby cohort study, comprising patients with CKD stage 3 at recruitment in primary care (baseline n=1741). Data included: age, sex, socioeconomic status (SES) based on index of multiple deprivation (IMD); comorbidities; renal function (estimated glomerular filtration rate (eGFR)); Karnofsky Performance Status (KPS). Functional impairment was defined as KPS score ≤70 (at best, unable to do active work or normal activities but can self-care; possible KPS score 0-100 in intervals of 10, lower score represents lower function). Binary logistic regression analyses assessed associations with functional impairment.


Cohort characteristics were: median age 77y, 62% female, mean eGFR 54 ml/min/1.73m2. 23% scored ≤70 on the KPS indicating low levels of functional impairment. On univariable analysis, functional impairment was associated with older age, lower SES, multiple comorbidities, and lower eGFR. In a multivariable model, these factors remained independently associated, and female sex became associated, with the outcome.


In addition to lower eGFR, older age, female sex, lower SES and multiple comorbidities were independent risk factors for clinician-assessed functional impairment in mild to moderate CKD. Persons with these risk factors should be considered for further functional status assessment and interventions to improve impairment.

OR (95% CI)p valueOR (95% CI)p value
Age (y)1.07 (1.05 - 1.09)<0.0011.06 (1.03 - 1.08)<0.001
Sex (vs male)Female1.16 (0.86 - 1.57)0.3291.52 (1.09 - 2.11)0.014
IMD national quintile
(vs least deprived)
Most deprived2.87 (1.61 - 5.11)0.0022.77 (1.50 - 5.10)0.001
(vs CKD only or CKD plus 1 other)
CKD plus ≥2 others3.95 (2.71 - 5.77)<0.0013.19 (2.15 - 4.74)<0.001
eGFR (ml/min/1.73m2)0.97 (0.96 - 0.98)<0.0010.98 (0.97 - 0.99)0.003

Adjusted for listed covariates. OR: odds ratio for functional impairment; CI: confidence interval.


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