Kidney Week

Abstract: SA-PO0397

Association of Cardiac Structure, Function, and Injury with Change in Physical Performance in Patients with CKD

Session Information

• CKM: Clinical - Epidemiology and Outcomes
  October 24, 2026 | Location: Exhibit Hall A, Convention Center
  Abstract Time: 10:00 AM - 12:00 PM

Category: Cardiovascular-Kidney-Metabolic Health

• 602 Cardiovascular-Kidney-Metabolic Health: Clinical

Authors

• Ramesh, Sharanya, Tufts Medical Center, Boston, Massachusetts, United States

Sharanya Ramesh, MD, PhD

• Shlipak, Michael G., San Francisco VA Health Care System, San Francisco, California, United States

Michael G. Shlipak, MD, MPH

• Brown, Rebecca T., University of Pennsylvania Perelman School of Medicine, Philadelphia, Pennsylvania, United States

Rebecca T. Brown, MD, MPH

• Tangri, Navdeep, University of Manitoba Max Rady College of Medicine, Winnipeg, Manitoba, Canada

Navdeep Tangri, MD, PhD

• Zhang, Xiaoming, University of Pennsylvania Perelman School of Medicine, Philadelphia, Pennsylvania, United States

Xiaoming Zhang

• Yang, Wei, University of Pennsylvania Perelman School of Medicine, Philadelphia, Pennsylvania, United States

Wei Yang, PhD

• Schrauben, Sarah J., University of Pennsylvania Perelman School of Medicine, Philadelphia, Pennsylvania, United States

Sarah J. Schrauben, MD, MS

Background

The relationship between cardiac health status and physical function is not well characterized in chronic kidney disease (CKD). We examined whether markers of cardiac structure, function, and injury and heart failure (HF) are associated with changes in physical performance in adults with moderate to severe CKD.

Methods

Participants from Chronic Renal Insufficiency Cohort Study, a prospective cohort with moderate to severe CKD, were included if they had at least one echocardiogram or cardiac biomarker measured and at least one Short Physical Performance Battery (SPPB) assessment performed in follow up. Baseline was defined as the time of cardiac exposure assessment, including measures of cardiac structure, function and injury: ejection fraction (EF), N-terminal pro-brain natriuretic peptide (NT-pro-BNP), left ventricular mass index (LVMI), E to A wave velocity ratio (E/A ratio), and high-sensitivity troponin, as well as occurence of HF hospitalization (time-updated). The outcome was time-updated SPPB. Associations with longitudinal SPPB were evaluated using multivariable adjusted linear mixed-effects models with time-by-exposure interactions to assess differences in rates of change.

Results

Among 1,103 participants, the mean age was 59 years, with mean eGFR of 50 ml/min/1.73m^2. EF, NT-proBNP, and E/A ratio were not associated with SPPB change. Higher LVMI and troponin levels were associated with greater declines in SPPB. Any HF hospitalization was associated with a steeper decline in SPPB (Table1).

Conclusion

In CKD, HF hospitalization, higher LVMI, and elevated troponin were linked to faster physical performance decline, even after accounting for age and kidney function. These findings suggest that markers of cardiac injury and remodeling are the most relevant cardiac health status measures for worsening physical performance in CKD.

Funding

• NIDDK Support