BACKGROUND: Poor physical performance and frailty are associated with elevated risks of death and disability. Chronic kidney disease (CKD) is also strongly associated with these outcomes. The risks of poor physical performance and frailty among CKD patients, however, are not well established. METHODS: We measured the Short Physical Performance Battery (SPPB; a summary test of gait speed, chair raises and balance; range 0-12) and the five elements of frailty among 1,111 Chronic Renal Insufficiency Cohort participants. Adjusting for demographics and multiple comorbidities, we fit a linear regression model for the outcome of SPPB score and an ordinal logistic regression model for frailty status. RESULTS: Median (interquartile range, IQR) age was 65 (57-71) years, median estimated glomerular filtration rate (eGFR) for non-dialysis patients was 49 (36-62) ml/min/1.73 m(2), and median SPPB score was 9 (7-10). Seven percent of participants were frail and 43% were pre-frail. Compared with the SPPB score for eGFR >60 ml/min/1.73 m(2), the SPPB was 0.51 points lower for eGFR 30-59; 0.61 points lower for eGFR 15-29, and 1.75 points lower for eGFR <15 (p < 0.01 for all comparisons). eGFR 30-59 (odds ratio, OR 1.45; p = 0.024), eGFR 15-29 (OR 2.02; p = 0.002) and eGFR <15 (OR 4.83; p < 0.001) were associated with worse frailty status compared with eGFR >60 ml/min/1.73 m(2). CONCLUSIONS: CKD severity was associated with poor physical performance and frailty in a graded fashion. Future trials should determine if outcomes for CKD patients with frailty and poor physical performance are improved by targeted interventions.
BACKGROUND: Poor physical performance and frailty are associated with elevated risks of death and disability. Chronic kidney disease (CKD) is also strongly associated with these outcomes. The risks of poor physical performance and frailty among CKDpatients, however, are not well established. METHODS: We measured the Short Physical Performance Battery (SPPB; a summary test of gait speed, chair raises and balance; range 0-12) and the five elements of frailty among 1,111 Chronic Renal Insufficiency Cohortparticipants. Adjusting for demographics and multiple comorbidities, we fit a linear regression model for the outcome of SPPB score and an ordinal logistic regression model for frailty status. RESULTS: Median (interquartile range, IQR) age was 65 (57-71) years, median estimated glomerular filtration rate (eGFR) for non-dialysis patients was 49 (36-62) ml/min/1.73 m(2), and median SPPB score was 9 (7-10). Seven percent of participants were frail and 43% were pre-frail. Compared with the SPPB score for eGFR >60 ml/min/1.73 m(2), the SPPB was 0.51 points lower for eGFR 30-59; 0.61 points lower for eGFR 15-29, and 1.75 points lower for eGFR <15 (p < 0.01 for all comparisons). eGFR 30-59 (odds ratio, OR 1.45; p = 0.024), eGFR 15-29 (OR 2.02; p = 0.002) and eGFR <15 (OR 4.83; p < 0.001) were associated with worse frailty status compared with eGFR >60 ml/min/1.73 m(2). CONCLUSIONS:CKD severity was associated with poor physical performance and frailty in a graded fashion. Future trials should determine if outcomes for CKDpatients with frailty and poor physical performance are improved by targeted interventions.
Authors: Michal L Melamed; Brad Astor; Erin D Michos; Thomas H Hostetter; Neil R Powe; Paul Muntner Journal: J Am Soc Nephrol Date: 2009-10-29 Impact factor: 10.121
Authors: L P Fried; C M Tangen; J Walston; A B Newman; C Hirsch; J Gottdiener; T Seeman; R Tracy; W J Kop; G Burke; M A McBurnie Journal: J Gerontol A Biol Sci Med Sci Date: 2001-03 Impact factor: 6.053
Authors: Linda F Fried; Robert Boudreau; Jung Sun Lee; Glenn Chertow; Manjula Kurella-Tamura; Michael G Shlipak; Jingzhong Ding; Deborah Sellmeyer; Frances A Tylavsky; Eleanor Simsonick; Stephen B Kritchevsky; Tamara B Harris; Anne B Newman Journal: J Am Geriatr Soc Date: 2007-10 Impact factor: 5.562
Authors: James P Lash; Alan S Go; Lawrence J Appel; Jiang He; Akinlolu Ojo; Mahboob Rahman; Raymond R Townsend; Dawei Xie; Denise Cifelli; Janet Cohan; Jeffrey C Fink; Michael J Fischer; Crystal Gadegbeku; L Lee Hamm; John W Kusek; J Richard Landis; Andrew Narva; Nancy Robinson; Valerie Teal; Harold I Feldman Journal: Clin J Am Soc Nephrol Date: 2009-06-18 Impact factor: 8.237
Authors: Sandrah P Eckel; Karen Bandeen-Roche; Paulo H M Chaves; Linda P Fried; Thomas A Louis Journal: Aging Clin Exp Res Date: 2011-06 Impact factor: 3.636
Authors: Jon Kobashigawa; Darshana Dadhania; Sangeeta Bhorade; Deborah Adey; Joseph Berger; Geetha Bhat; Marie Budev; Andres Duarte-Rojo; Michael Dunn; Shelley Hall; Meera N Harhay; Kirsten L Johansen; Susan Joseph; Cassie C Kennedy; Evan Kransdorf; Krista L Lentine; Raymond J Lynch; Mara McAdams-DeMarco; Shunji Nagai; Michael Olymbios; Jignesh Patel; Sean Pinney; Joanna Schaenman; Dorry L Segev; Palak Shah; Lianne G Singer; Jonathan P Singer; Christopher Sonnenday; Puneeta Tandon; Elliot Tapper; Stefan G Tullius; Michael Wilson; Martin Zamora; Jennifer C Lai Journal: Am J Transplant Date: 2018-12-22 Impact factor: 8.086
Authors: Ariane T Michelson; Demetra S Tsapepas; S Ali Husain; Corey Brennan; Mariana C Chiles; Brian Runge; Jennifer Lione; Byum H Kil; David J Cohen; Lloyd E Ratner; Sumit Mohan Journal: Clin Transplant Date: 2018-10-28 Impact factor: 2.863
Authors: Matthew K Abramowitz; William Paredes; Kehao Zhang; Camille R Brightwell; Julia N Newsom; Hyok-Joon Kwon; Matthew Custodio; Rupinder S Buttar; Hina Farooq; Bushra Zaidi; Rima Pai; Jeffrey E Pessin; Meredith Hawkins; Christopher S Fry Journal: Am J Physiol Renal Physiol Date: 2018-10-03
Authors: Natalie Daya; Annie Voskertchian; Andrea L C Schneider; Shoshana Ballew; Mara McAdams DeMarco; Josef Coresh; Lawrence J Appel; Elizabeth Selvin; Morgan E Grams Journal: Am J Kidney Dis Date: 2015-08-04 Impact factor: 8.860