Lower Extremity Physical Performance Tests May Help Identify Kidney Disease Patients At Risk For Premature Death

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Lower Extremity Physical Performance Tests May Help Identify Kidney
Disease Patients At Risk For Premature Death
22 Apr 2013

Kidney disease patients who have slower walking speed on physical
performance tests seem to be more burdened by their disease than
patients who perform well on lower extremity physical performance
tests, according to a study appearing in an upcoming issue of the
Journal of the American Society of Nephrology (JASN). The findings
indicate that measuring lower extremity physical performance may
capture a complex set of skeletal muscle and neurologic impairments
that develop in CKD patients and substantially affect their survival.

Individuals with chronic kidney disease (CKD) have increased risks of
becoming frail or disabled - somewhat like the elderly - and of dying
from heart-related problems. Physical performance tests are often used
to assess frailty and overall health in the elderly, but little is
known about whether physical performance might be used to identify
younger CKD patients at high risk of dying prematurely.

To study the issue, Baback Roshanravan, MD MS (Kidney Research
Institute, Division of Nephrology at the University of Washington) and
his colleagues followed 385 patients with CKD without a history of
stroke or disability and with an average age of 61 years. The
researchers compared handgrip strength, usual walking speed,
six-minute walking distance, and timed up and go (the time that a
person takes to rise from a chair, walk four meters, turn around, walk
back to the chair, and sit down).

Among the major findings during the average three-year follow-up
period:
Measures of lower extremity performance were at least 30% lower than
predicted, but handgrip strength was relatively preserved.
Each 0.1-meter per second slower walking speed was linked with a 26%
higher risk for death over an average three-year follow-up period, and
each one-second longer timed up and go was linked with an 8% higher
risk for death.
Walking speed and timed up and go more strongly predicted three-year
mortality than kidney function or common blood tests.
Adding walking speed to common laboratory tests of kidney function
significantly improved the prediction of three-year mortality.
The results indicate that impaired physical performance of the lower
extremities is common in CKD and is strongly linked with premature
death. "Our findings suggest that lower extremity physical performance
testing in chronic kidney disease patients may help identify those
individuals who are more burdened by their chronic kidney disease,"
said Dr. Roshanravan.

"Further studies will be necessary to examine the causal factors that
are responsible for these findings," wrote Joel Kopple, MD (UCLA and
the Los Angeles Biomedical Research Institute) in an accompanying
editorial. "Given the current high interest in the problem of frailty
in CKD patients, it can be anticipated that much new information," he
added.
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References:

Study co-authors include Cassianne Robinson-Cohen, PhD, Kushang Patel,
PhD, Ernest Ayers, Alyson Littman, PhD, Ian de Boer, MD, T. Alp
Ikizler, MD, Jonathan Himmelfarb, MD, Leslie Katzel, MD, PhD, Bryan
Kestenbaum, MD, and Stephen Seliger, MD.

Disclosures: Dr. Baback Roshanravan was funded by a Ruth L.
Kirschstein National Research Service Award (NRSA) and T32 grant from
the National Institute of Diabetes and Digestive and Kidney Diseases
(NIDDK). The authors reported no other financial disclosures.

The article, entitled "Association between Physical Performance and
All-Cause Mortality in CKD," appeared online at
http://jasn.asnjournals.org/ on April 18, 2013, doi:
10.1681/ASN.2012070702.

The editorial, entitled "Physical Performance and All-Cause Mortality
in CKD," appeared online at http://jasn.asnjournals.org/ on April 18,
2013, doi: 10.1681/ASN.2013030307.

American Society of Nephrology


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Citations:

Please use one of the following formats to cite this article in your
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MLA
American Society of Nephrology. "Lower Extremity Physical Performance
Tests May Help Identify Kidney Disease Patients At Risk For Premature
Death." Medical News Today. MediLexicon, Intl., 22 Apr. 2013. Web.
24 Apr. 2013. <http://www.medicalnewstoday.com/releases/259348.php>
APA
American Society of Nephrology. (2013, April 22). "Lower Extremity
Physical Performance Tests May Help Identify Kidney Disease Patients
At Risk For Premature Death." Medical News Today. Retrieved from
http://www.medicalnewstoday.com/releases/259348.php.
Please note: If no author information is provided, the source is cited
instead.