Abstract: FR-PO534
Factors Associated with Functional Impairment in Mild to Moderate CKD
Session Information
- Physical Activity, Body Composition, Metabolism: Clinical
October 26, 2018 | Location: Exhibit Hall, San Diego Convention Center
Abstract Time: 10:00 AM - 12:00 PM
Category: CKD (Non-Dialysis)
- 1902 CKD (Non-Dialysis): Clinical, Outcomes, and Trials
Authors
- 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
Background
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.
Methods
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.
Results
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.
Conclusion
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.
| Univariable | Multivariable† | ||||
| OR (95% CI) | p value | OR (95% CI) | p value | ||
| Age (y) | 1.07 (1.05 - 1.09) | <0.001 | 1.06 (1.03 - 1.08) | <0.001 | |
| Sex (vs male) | Female | 1.16 (0.86 - 1.57) | 0.329 | 1.52 (1.09 - 2.11) | 0.014 |
| IMD national quintile (vs least deprived) | Most deprived | 2.87 (1.61 - 5.11) | 0.002 | 2.77 (1.50 - 5.10) | 0.001 |
| Comorbidities (vs CKD only or CKD plus 1 other) | CKD plus ≥2 others | 3.95 (2.71 - 5.77) | <0.001 | 3.19 (2.15 - 4.74) | <0.001 |
| eGFR (ml/min/1.73m2) | 0.97 (0.96 - 0.98) | <0.001 | 0.98 (0.97 - 0.99) | 0.003 | |
†Adjusted for listed covariates. OR: odds ratio for functional impairment; CI: confidence interval.
Funding
- Commercial Support – Roche Products plc