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Kidney Week

Abstract: PO2418

Associations of eGFR and Albuminuria with Physical Performance

Session Information

Category: CKD (Non-Dialysis)

  • 2102 CKD (Non-Dialysis): Clinical, Outcomes, and Trials

Authors

  • Mello, Ryan, Hennepin Healthcare, Minneapolis, Minnesota, United States
  • Hart, Allyson, Hennepin Healthcare, Minneapolis, Minnesota, United States
  • Murray, Anne M., Hennepin Healthcare, Minneapolis, Minnesota, United States
  • Davey, Cynthia S., University of Minnesota Medical School Twin Cities, Minneapolis, Minnesota, United States
  • Johansen, Kirsten L., Hennepin Healthcare, Minneapolis, Minnesota, United States
Background

Reduced physical performance is associated with increased all-cause mortality, and individuals with chronic kidney disease (CKD) are at an increased risk of suffering from impaired physical function. However, most studies have not included assessment of albuminuria. We hypothesized that eGFR and albuminuria would be independently associated with physical performance.

Methods

The Brain in Kidney Disease (BRINK) cohort was designed to examine cognitive and physical function among adults with CKD. Intentional recruitment ensured participants with an eGFR (ml/min/1.73m2) range from <30 to 59 were included, in addition to a control group with eGFR ≥60. We estimated GFR using creatinine (eGFRCr) and, in separate analyses, cystatin C (eGFRCysC), and measured urine albumin to creatinine ration (UACR). We assessed physical performance using the Short Physical Performance Battery (SPPB; range 0-12). 571 community-dwelling adults with baseline SPPB scores were included. Univariate and multivariable logistic regression models, adjusted for demographics and comorbidity, examined associations of eGFR and UACR with SPPB <10.

Results

Mean age was 69.3 years. 157 (27.5%) participants had eGFRCr <30, 276 (48.3%) 30 to <60, and 138 (24.2%) ≥60. In separate univariate analyses, both lower eGFRCr and higher UACR were associated with higher odds of low SPPB (Table). In the adjusted model with eGFRCr, UACR and covariates, UACR retained a significant association with low SPPB, but eGFRCr did not. Similar results were found in models with eGFRCysC and UACR.

Conclusion

Both low eGFRCr and high UACR were associated with poor physical performance in univariate analyses, but only UACR remained associated in the fully adjusted model. Similar results with eGFRCysC suggest that confounding based on muscle mass does not explain the lack of association between eGFRCr and physical performance and raises the possibility that vascular or endothelial function may be important factors.

* Model with both eGFRCr, and UACR and adjusted for low hemoglobin, low bicarbonate, low albumin, pulse pressure, diabetes, BMI group, CVD, CHF, Stroke/TIA, smoking, Black race, gender, age, and years of education.

Funding

  • NIDDK Support