Hee-Won Jung1, In Young Choi2, Dong Wook Shin3,4, Kyungdo Han5, Jung Eun Yoo6, Sohyun Chun7, Yongjin Yi8. 1. Division of Geriatrics, Department of Internal Medicine, Asan Medical Center, University of Ulsan College of Medicine, Seoul, South Korea. 2. Total Healthcare Center, Kangbuk Samsung Hospital, B1, Samsung Main B/D, 67, Sejong-daero, Jung-gu, Seoul, 04514, South Korea. 3. Total Healthcare Center, Kangbuk Samsung Hospital, B1, Samsung Main B/D, 67, Sejong-daero, Jung-gu, Seoul, 04514, South Korea. dwshin.md@gmail.com. 4. Department of Digital Health, SAIHST, Sungkyunkwan University, 81 Irwon-Ro, Gangnam-gu, Seoul, 06351, South Korea. dwshin.md@gmail.com. 5. Department of Statistics and Actuarial Science, Soongsil University, Seoul, South Korea. 6. Department of Family Medicine, Healthcare system Gangnam Center, Seoul National University Hospital, Seoul, South Korea. 7. International Healthcare Center, Samsung Medical Center, Seoul, South Korea. 8. Division of Nephrology, Dankook University Hospital, Cheonan-si, Chungcheongnam-do, South Korea.
Abstract
BACKGROUND: Physical frailty has previously been associated with adverse clinical outcomes in patients with end-stage renal disease (ESRD). This study aimed to determine whether impaired physical performance at baseline is associated with the incidence of ESRD, using a nationwide database. METHODS: The timed up-and-go (TUG) test was used to assess physical frailty in 1,552,781 66-year-old individuals, using health examination database records from the Korean National Health Insurance Service. As a primary endpoint, incident ESRD was defined operationally using healthcare claims data from the Korean Health Insurance Review and Assessment Service. RESULTS: Our results showed that baseline kidney function was significantly worse in individuals with TUG results of > 10 s compared to individuals with an intact TUG performance (≤10 s). Kaplan-Meier analysis showed a stepwise dose-response relationship between baseline physical performance and the incidence rate of ESRD (log-rank test P-value of < 0.001). An increasing ESRD incidence rate trend with poor physical performance remained significant after adjusting for characteristics such as baseline glomerular filtration rate and proteinuria. CONCLUSION: Poor baseline physical performance was associated with an increased risk of ESRD, suggesting possible interactions between systemic frailty and vascular aging processes.
BACKGROUND: Physical frailty has previously been associated with adverse clinical outcomes in patients with end-stage renal disease (ESRD). This study aimed to determine whether impaired physical performance at baseline is associated with the incidence of ESRD, using a nationwide database. METHODS: The timed up-and-go (TUG) test was used to assess physical frailty in 1,552,781 66-year-old individuals, using health examination database records from the Korean National Health Insurance Service. As a primary endpoint, incident ESRD was defined operationally using healthcare claims data from the Korean Health Insurance Review and Assessment Service. RESULTS: Our results showed that baseline kidney function was significantly worse in individuals with TUG results of > 10 s compared to individuals with an intact TUG performance (≤10 s). Kaplan-Meier analysis showed a stepwise dose-response relationship between baseline physical performance and the incidence rate of ESRD (log-rank test P-value of < 0.001). An increasing ESRD incidence rate trend with poor physical performance remained significant after adjusting for characteristics such as baseline glomerular filtration rate and proteinuria. CONCLUSION: Poor baseline physical performance was associated with an increased risk of ESRD, suggesting possible interactions between systemic frailty and vascular aging processes.
Entities:
Keywords:
Chronic kidney disease; Frailty; Morbidity; Physical function
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