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Kidney Week

Abstract: PO1687

Correlation Between Patient-Reported Physical Limitation and Objective Physical Performance on the Repeated Chair Stand Test Among Patients with Non-Dialysis Dependent CKD and Metabolic Acidosis

Session Information

Category: Geriatric Nephrology

  • 1100 Geriatric Nephrology

Authors

  • Mathur, Vandana S., MathurConsulting, Woodside, California, United States
  • Walker, Michael, Walker Biosciences, Carlsbad, California, United States
  • Klaerner, Gerrit, Tricida, Inc., South San Francisco, California, United States
Background

CKD accelerates the loss of physical function, in part due to the development of sarcopenia caused by metabolic acidosis (MA). Decline in the ability to rise from a seated position is consequential as it can lead to loss of independence. However, physical performance is not routinely measured in CKD clinical practice.

Methods

We evaluated the correlation between patient-reported limitation on daily activities on the Kidney Disease and Quality of Life Physical Function Domain (KDQOL-PFD, a 10-item survey in which possible responses are “not limited at all”, “limited a little”, and “limited a lot”) and the standardized 5-times repeat chair stand time (RCS) using data from a 1 year randomized trial of pts (N = 196) with MA in CKD (Wesson et al. The Lancet, 2019). These measures showed an ability to detect change - pts in the veverimer group improved significantly on both.

Results

There was a significant, direct correlation between improvement (i.e., higher score) over 1 yr on the KDQOL-PFD total score and improvement on the RCS (i.e., faster time), (Pearson’s product-moment correlation, 0.33, P < 0.001). Additionally, 5 of the 10 individual KDQOL-PFD activity limitations correlated significantly with RCS time: “lifting or carrying groceries”; “bending, kneeling, or stooping”; “walking one block”, “walking several blocks”, and “bathing or dressing yourself” (P-value < 0.05 for the correlation for all questions). Using a linear model, we found that each category of decline in the KDQOL-PFD for these individual questions was associated with significant deterioration of RCS time in the range of 3.29 to 3.80 seconds, exceeding the minimally clinically important difference of 1.7 seconds (Jones et al. Thorax, 2013).

Conclusion

Our findings suggest that asking pts if they are limited in their ability to do daily activities such as walking 1 block or lifting or carrying groceries may be a practical way to screen for significant physical performance declines known to have important health, social, and economic consequences. Routine identification of pts with physical functional decline might allow for earlier implementation of interventions to forestall further impairment.

Funding

  • Commercial Support