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Abstract: FR-PO533

Impaired Muscle Mitochondrial Energetics Is Associated with Poor Physical Performance and Reduced Objective Physical Activity in CKD

Session Information

Category: Health Maintenance, Nutrition, and Metabolism

  • 1302 Health Maintenance, Nutrition, and Metabolism: Clinical

Authors

  • Roshanravan, Baback, University of Washington - Kidney Research Institute, Seattle, Washington, United States
  • Liu, Sophia, University of Washington, Seattle, Washington, United States
  • Patel, Kushang V., University of Washington, Seattle, Washington, United States
  • Gamboa, Jorge, Vanderbilt University, Nashville, Tennessee, United States
  • Ali, Amir Safi, University of Washington, Seattle, Washington, United States
  • Himmelfarb, Jonathan, University of Washington - Kidney Research Institute, Seattle, Washington, United States
  • de Boer, Ian H., University of Washington - Kidney Research Institute, Seattle, Washington, United States
  • Conley, Kevin, University of Washington, Seattle, Washington, United States
  • Kestenbaum, Bryan R., University of Washington - Kidney Research Institute, Seattle, Washington, United States
Background

Persons with chronic kidney disease (CKD) are at increased risk of impaired mobility function that is central to living independently. The abnormal uremic milieu of CKD may contribute to reduced ambulatory physical performance and sedentarism by impairing skeletal muscle mitochondrial metabolism.

Methods

We performed a cross-sectional analysis of 48 participants (37 with CKD not treated with dialysis and 11 matched, clinic-based controls without CKD) from the Muscle Mitochondrial ENergetics and Dysfunction (MEND) study. Persons were excluded from MEND if they used medications that influenced mitochondrial metabolism or had mobility disability. We measured mitochondrial capacity during the recovery from exercise of the tibialis anterior leg muscle as ATPmax using 31Phosphorus magnetic resonance spectroscopy. We assessed ambulatory physical performance by the 6-minute walk and timed up and go tests and we quantified usual physical activity levels using digital accelerometry over a two-week period. Results were adjusted for age, sex, weight, diabetes, and leg muscle size.

Results

Among persons with CKD, the mean GFR was 36 ±15 ml/min; mean age was 62 ±15yr; 50% were female, and 30% had diabetes. After adjustment, patients with CKD had a 0.181mM/sec (1SD) lower muscle ATPmax compared with controls (95% CI 0.06-0.297 lower; P=0.003). Among those with CKD greater muscle ATPmax was associated with greater 6 minute walk distance (A), faster timed up and go performance (B) and greater usual physical activity (C) (Figure).

Conclusion

CKD is associated with lower muscle mitochondrial capacity measured by ATPmax manifesting as poor ambulatory physical performance. Among CKD patients, mitochondrial capacity is associated with objective measurements of physical performance and activity.

Funding

  • NIDDK Support