Abstract: FR-PO0283
Objective vs. Self-Reported Physical Function and Mortality in CKD
Session Information
- CKD: Omics, Systemic Stressors, and Targeted Pharmacotherapy
October 23, 2026 | Location: Exhibit Hall A, Convention Center
Abstract Time: 10:00 AM - 12:00 PM
Category: CKD (Non-Dialysis)
- 2201 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 G., San Francisco VA Health Care System, San Francisco, California, United States
- Tangri, Navdeep, University of Manitoba Max Rady College of Medicine, Winnipeg, Manitoba, Canada
- Zhang, Xiaoming, University of Pennsylvania Perelman School of Medicine, Philadelphia, Pennsylvania, United States
- Yang, Wei, University of Pennsylvania Perelman School of Medicine, Philadelphia, Pennsylvania, United States
Background
Physical function is a key determinant of health and independence in chronic kidney disease (CKD), yet objective and subjective measures are variably used in practice. While both are associated with adverse outcomes, their relative prognostic value and longitudinal relationship remain unclear. We compared objective physical performance, measured by the Short Physical Performance Battery (SPPB), with self-reported physical function, measured by the SF-12 Physical Component Summary (PCS-12), in relation to mortality in CKD.
Methods
We studied participants from the Chronic Renal Insufficiency Cohort (CRIC) Study with concurrent SPPB and PCS-12 assessments at baseline and longitudinally. SPPB (range 0–12) and PCS-12 (range 0–100), both measures with higher scores reflecting better physical function, were modeled at baseline and as time-updated exposures. Correlations were assessed cross-sectionally and longitudinally. Associations with mortality were evaluated using multivariable adjusted Cox models.
Results
Among 3,114 participants, mean age was 64 years, mean eGFR was 49 ml/min/1.73m^2, and 43% were female. Baseline mean (SD) SPPB and PCS-12 scores were 8.9 (2.6) and 41.5 (11.5), with moderate correlation (r=0.47, p<0.001). Longitudinal changes were weakly correlated (r=0.17, p<0.001). Over a median of 8.5 years, lower SPPB and PCS-12 scores were both associated with higher mortality risk in fully adjusted models that included both measures; however, SPPB showed a stronger association with mortality than longitudinal PCS-12 (Table 1).
Conclusion
Assessments of physical function are critically important for understanding prognosis among persons with CKD. Although objective measures appear more strongly associated with mortality, their use may be limited by feasibility.
Associations of baseline and time-updated SPPB and PCS-12 with mortality in multivariable adjusted Cox models including both measures.
| Baseline HR (95% CI) | Time-Updated HR (95% CI) | |
| PCS-12 per ½ IQR lower (10 points) | 1.10 (1.01-1.20) | 1.18 (1.08-1.30) |
| SPPB per ½ IQR lower (2 points) | 1.24 (1.15-1.33) | 1.31 (1.16-1.47) |
| Abbreviations: PCS-12: Physical Component Summary of SF-12; SPPB: Short Physical Performance Battery; HR: Hazard Ratio; CI: Confidence Interval Models adjusted for sex, age, race, education, cohort recruitment site and enrollment phase, time-updated: diabetes, smoking, systolic blood pressure, body mass index, estimated glomerular filtration rate, urinary albumin-to-creatinine ratio, hemoglobin, physical activity, Beck’s depression index score | ||
Funding
- NIDDK Support