Baback Roshanravan1, Kushang V Patel2, Cassianne Robinson-Cohen3, Ian H de Boer3, Ann M O'Hare4, Luigi Ferrucci5, Jonathan Himmelfarb3, Bryan Kestenbaum3. 1. Division of Nephrology, Department of Medicine, University of Washington Kidney Research Institute, Seattle, WA. Electronic address: broshanr@u.washington.edu. 2. Department of Anesthesiology and Pain Medicine, University of Washington, Seattle, WA. 3. Division of Nephrology, Department of Medicine, University of Washington Kidney Research Institute, Seattle, WA. 4. Veterans Affairs Puget Sound Healthcare System, University of Washington, Seattle, WA. 5. Intramural Research Program, National Institute on Aging, National Institutes of Health, Baltimore, MD.
Abstract
BACKGROUND: Chronic kidney disease is associated with malnutrition and inflammation. These processes may lead to loss of skeletal muscle and reduced physical performance. Associations of kidney function with muscle composition and longitudinal measures of physical performance are unknown. STUDY DESIGN: Prospective cohort study. SETTING & PARTICIPANTS: We evaluated 826 community-dwelling older adults enrolled in the Invecchiare in Chianti (InCHIANTI) Study who were free of baseline stroke or activities of daily living disability. PREDICTOR: Baseline creatinine clearance (Clcr) based on 24-hour urine collection. OUTCOMES: Cross-sectional and longitudinal trajectories of physical performance measured by 7-m usual gait speed, 400-m fast gait speed, and knee extension strength using isometric dynamometry. Calf muscle composition assessed by quantitative computed tomography. RESULTS: Mean age of participants was 74 ± 7 (SD) years, with 183 having Clcr < 60 mL/min/1.73 m(2). After adjustment, each 10-mL/min/1.73 m(2) decrement in Clcr was associated with 0.01 (95% CI, 0.004-0.017) m/s slower 7-m usual walking speed and 0.008 (95% CI, 0.002-0.014) m/s slower 400-m walking speed. Each 10-mL/min/1.73 m(2) decrement in Clcr was associated with 28 (95% CI, 0.8-55) mm(2) lower muscle area and 0.15 (95% CI, 0.04-0.26) mg/cm(3) lower muscle density. After adjustment, lower Clcr was associated with slower mean 7-m (P=0.005) and 400-m (P=0.02) walk and knee extension strength (P=0.001) during the course of follow-up. During a mean follow-up of 7.1 ± 2.5 years, each 10-mL/min/1.73 m(2) lower baseline Clcr was associated with 0.024 (95% CI, 0.01-0.037) kg/y greater decline in knee strength. LIMITATIONS: Single baseline measurement of Clcr and 3-year interval between follow-up visits may lead to nondifferential misclassification and attenuation of estimates. CONCLUSIONS: Among older adults, lower Clcr is associated with muscle atrophy, reduced walking speed, and more rapid declines in lower-extremity strength over time.
BACKGROUND:Chronic kidney disease is associated with malnutrition and inflammation. These processes may lead to loss of skeletal muscle and reduced physical performance. Associations of kidney function with muscle composition and longitudinal measures of physical performance are unknown. STUDY DESIGN: Prospective cohort study. SETTING & PARTICIPANTS: We evaluated 826 community-dwelling older adults enrolled in the Invecchiare in Chianti (InCHIANTI) Study who were free of baseline stroke or activities of daily living disability. PREDICTOR: Baseline creatinine clearance (Clcr) based on 24-hour urine collection. OUTCOMES: Cross-sectional and longitudinal trajectories of physical performance measured by 7-m usual gait speed, 400-m fast gait speed, and knee extension strength using isometric dynamometry. Calf muscle composition assessed by quantitative computed tomography. RESULTS: Mean age of participants was 74 ± 7 (SD) years, with 183 having Clcr < 60 mL/min/1.73 m(2). After adjustment, each 10-mL/min/1.73 m(2) decrement in Clcr was associated with 0.01 (95% CI, 0.004-0.017) m/s slower 7-m usual walking speed and 0.008 (95% CI, 0.002-0.014) m/s slower 400-m walking speed. Each 10-mL/min/1.73 m(2) decrement in Clcr was associated with 28 (95% CI, 0.8-55) mm(2) lower muscle area and 0.15 (95% CI, 0.04-0.26) mg/cm(3) lower muscle density. After adjustment, lower Clcr was associated with slower mean 7-m (P=0.005) and 400-m (P=0.02) walk and knee extension strength (P=0.001) during the course of follow-up. During a mean follow-up of 7.1 ± 2.5 years, each 10-mL/min/1.73 m(2) lower baseline Clcr was associated with 0.024 (95% CI, 0.01-0.037) kg/y greater decline in knee strength. LIMITATIONS: Single baseline measurement of Clcr and 3-year interval between follow-up visits may lead to nondifferential misclassification and attenuation of estimates. CONCLUSIONS: Among older adults, lower Clcr is associated with muscle atrophy, reduced walking speed, and more rapid declines in lower-extremity strength over time.
Authors: Baback Roshanravan; Minesh Khatri; Cassianne Robinson-Cohen; Greg Levin; Kushang V Patel; Ian H de Boer; Stephen Seliger; John Ruzinski; Jonathan Himmelfarb; Bryan Kestenbaum Journal: Am J Kidney Dis Date: 2012-07-07 Impact factor: 8.860
Authors: Laura C Plantinga; Kirsten Johansen; Deidra C Crews; Vahakn B Shahinian; Bruce M Robinson; Rajiv Saran; Nilka Ríos Burrows; Desmond E Williams; Neil R Powe Journal: Am J Kidney Dis Date: 2010-10-30 Impact factor: 8.860
Authors: Mary M McDermott; Kiang Liu; Lu Tian; Jack M Guralnik; Michael H Criqui; Yihua Liao; Luigi Ferrucci Journal: J Am Coll Cardiol Date: 2012-03-27 Impact factor: 24.094
Authors: Stephanie Studenski; Subashan Perera; Kushang Patel; Caterina Rosano; Kimberly Faulkner; Marco Inzitari; Jennifer Brach; Julie Chandler; Peggy Cawthon; Elizabeth Barrett Connor; Michael Nevitt; Marjolein Visser; Stephen Kritchevsky; Stefania Badinelli; Tamara Harris; Anne B Newman; Jane Cauley; Luigi Ferrucci; Jack Guralnik Journal: JAMA Date: 2011-01-05 Impact factor: 56.272
Authors: Lesley A Inker; Christopher H Schmid; Hocine Tighiouart; John H Eckfeldt; Harold I Feldman; Tom Greene; John W Kusek; Jane Manzi; Frederick Van Lente; Yaping Lucy Zhang; Josef Coresh; Andrew S Levey Journal: N Engl J Med Date: 2012-07-05 Impact factor: 91.245
Authors: Gregory E Hicks; Michelle Shardell; Dawn E Alley; Ram R Miller; Stefania Bandinelli; Jack Guralnik; Fulvio Lauretani; Eleanor M Simonsick; Luigi Ferrucci Journal: J Gerontol A Biol Sci Med Sci Date: 2011-05-05 Impact factor: 6.053
Authors: Baback Roshanravan; Cassianne Robinson-Cohen; Kushang V Patel; Ernest Ayers; Alyson J Littman; Ian H de Boer; T Alp Ikizler; Jonathan Himmelfarb; Leslie I Katzel; Bryan Kestenbaum; Stephen Seliger Journal: J Am Soc Nephrol Date: 2013-04-18 Impact factor: 10.121
Authors: Kristen M Beavers; Daniel P Beavers; Denise K Houston; Tamara B Harris; Trisha F Hue; Annemarie Koster; Anne B Newman; Eleanor M Simonsick; Stephanie A Studenski; Barbara J Nicklas; Stephen B Kritchevsky Journal: Am J Clin Nutr Date: 2013-01-30 Impact factor: 7.045
Authors: Baback Roshanravan; Leila R Zelnick; Daniel Djucovic; Haiwei Gu; Jessica A Alvarez; Thomas R Ziegler; Jorge L Gamboa; Kristina Utzschneider; Bryan Kestenbaum; Jonathan Himmelfarb; Steven E Kahn; Daniel Raftery; Ian H de Boer Journal: JCI Insight Date: 2018-08-23
Authors: Baback Roshanravan; Kushang V Patel; Linda F Fried; Cassianne Robinson-Cohen; Ian H de Boer; Tamara Harris; Rachel A Murphy; Suzanne Satterfield; Bret H Goodpaster; Michael Shlipak; Anne B Newman; Bryan Kestenbaum Journal: J Gerontol A Biol Sci Med Sci Date: 2016-10-21 Impact factor: 6.053
Authors: Ranjani N Moorthi; Simit Doshi; Linda F Fried; Sharon M Moe; Mark J Sarnak; Suzanne Satterfield; Ann V Schwartz; Michael Shlipak; Brittney S Lange-Maia; Tamara B Harris; Anne B Newman; Elsa S Strotmeyer Journal: Nephrol Dial Transplant Date: 2019-04-01 Impact factor: 5.992
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: Alyson M Cavanaugh; Andrea Z LaCroix; Donna Kritz-Silverstein; Eileen Rillamas-Sun; Dena E Rifkin Journal: J Am Geriatr Soc Date: 2016-09-21 Impact factor: 5.562
Authors: M Da Boit; S Tommasi; D Elliot; A Zinellu; S Sotgia; R Sibson; J R Meakin; R M Aspden; C Carru; A A Mangoni; S R Gray Journal: J Nutr Health Aging Date: 2018 Impact factor: 4.075