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Abstract: TH-PO1062

Longitudinal Changes in Physical Performance and Strength in People with CKD

Session Information

Category: CKD (Non-Dialysis)

  • 2301 CKD (Non-Dialysis): Epidemiology, Risk Factors, and Prevention

Authors

  • Schrauben, Sarah J., University of Pennsylvania Perelman School of Medicine, Philadelphia, Pennsylvania, United States
  • Brown, Rebecca T., University of Pennsylvania Perelman School of Medicine, Philadelphia, Pennsylvania, United States
  • Shlipak, Michael, San Francisco VA Health Care System, San Francisco, California, United States
  • Tangri, Navdeep, University of Manitoba, Winnipeg, Manitoba, Canada
  • Leonard, Mary B., Stanford University School of Medicine, Stanford, California, United States
  • Fischer, Michael J., University of Illinois Chicago, Chicago, Illinois, United States
  • Lash, James P., University of Illinois Chicago, Chicago, Illinois, United States
  • Navaneethan, Sankar D., Baylor College of Medicine, Houston, Texas, United States
  • Chen, Jing, The University of Texas Southwestern Medical Center, Dallas, Texas, United States
  • Rincon-Choles, Hernan, Cleveland Clinic, Cleveland, Ohio, United States
  • Appel, Lawrence J., Johns Hopkins Medicine, Baltimore, Maryland, United States
  • Hamm, L. Lee, Tulane University School of Medicine, New Orleans, Louisiana, United States
  • Yang, Wei, University of Pennsylvania Perelman School of Medicine, Philadelphia, Pennsylvania, United States
Background

We evaluated changes in physical performance and grip strength in a cohort of people with chronic kidney disease (CKD).

Methods

The Chronic Renal Insufficiency Cohort (CRIC) Study assessed grip strength (kg) and the Short Physical Performance Battery (SPPB) (score 0-12) and its components: gait speed (meters/second), 5-repetition chair stands (seconds), and balance stands at intervals of 2-3 years. Mixed-effects linear models estimated annual changes in performance and strength (or collectively, physical function), adjusted for age (per 10 years), sex, and estimated glomerular filtration rate (eGFR) groups (≥60, 45 to <60, 30 to <45, <30 or end-stage kidney disease). We compared differences in change by age, sex, and eGFR group. Performance tests and strength were categorized as abnormal based on published cut off values.

Results

Among 3,955 participants (mean age 62 years), baseline physical function was abnormal for 10-60%, and the prevalence increased monotonically for CKD stages. See Figure 1: SPPB abnormality prevalence. Over a median follow up 8.5 years, on average, physical function declined. Over time, a 10-year increase in age was associated with physical function changes similar in magnitude to each lower eGFR group, compared to eGFR >60: gait speed declined 0.005 m/s per decade vs. decline of 0.008, 0.01, and 0.02 m/s per lower eGFR group; male grip strength declined 0.16 kg/decade vs. 0.16, 0.31, and 0.50 kg per lower eGFR group; chair stand increased by 0.04 sec/decade vs. 0.06, 0.11, and 0.13 sec per lower eGFR group; SPPB score declined by 0.06 per decade vs 0.08, 0.15, and 0.19 decline per lower eGFR group.

Conclusion

In individuals with CKD, a 10-year increase in age produced physical function declines comparable in magnitude to the change associated with a 15 ml/min/1.73m^2 decline in eGFR. Abnormal physical function was highly prevalent at baseline and worsened over time, especially with more advanced CKD, underscoring the clinical importance of routine physicla function assessments in CKD.

Funding

  • NIDDK Support

Digital Object Identifier (DOI)