Assessment and monitoring of physical function for people with CKD.

Although low and deteriorating physical function are increasingly recognized as key characteristics of CKD, assessment of physical function does not yet form part of the routine clinical monitoring of this patient group. This is somewhat surprising as measures of physical function, from across the entire functional measurement spectrum, have been shown to be related to clinically important outcomes (morbidity, quality of life and increasingly survival) in patients being treated for CKD. In order to promote a standardized approach to assessment of people with CKD, it is recommended that renal professionals adopt the physical function and measurement classification systems of the International Classification Framework of Functioning, Disability and Health. Selection of physical function assessment "tool(s)" is influenced by the intended goal of the assessment (e.g., clinical assessment, tracking of progress with physical activity, research purposes, diagnostic purposes), the personal characteristics of the patient, and also by the prevailing information quality requirements and potential operational constraints (e.g., measurement burden, patient inclusiveness/sample size, cost). As exercise tolerance, functional capacity, and functional status assessments have been shown to be safe, feasible, and clinically useful, it is recommended that their implementation be incorporated within clinical management protocols for the patient with CKD.