Chronic Kidney Disease and Functional Limitation in Older People: Health, Aging and Body Composition Study

Publisher Website
Google Scholar
Abstract
OBJECTIVES: To assess whether chronic kidney disease (CKD) is independently associated with incident physical‐function limitation.DESIGN: Prospective cohort study.SETTING: Two sites: Pittsburgh, Pennsylvania, and Memphis, Tennessee.PARTICIPANTS: Two thousand one hundred thirty‐five men and women aged 70 to 79 without functional limitation at baseline from the Health, Aging and Body Composition Study.MEASUREMENTS: Functional limitation was defined as difficulty in walking one‐quarter of a mile or climbing 10 steps on two consecutive reports 6 months apart (in the same function). Kidney function was measured using serum cystatin C. Estimated glomerular filtration rate (eGFR), using the Modification of Diet in Renal Disease formula (2), was a secondary predictor. Muscle strength, lean body mass according to dual energy x‐ray absorptiometry, comorbidity, medication use, and inflammatory markers were evaluated as covariates.RESULTS: Persons in the highest (≥1.13 mg/L) quartile of cystatin C experienced a significantly higher risk of developing functional limitation than those in the lowest (2, although the association with functional limitation remained after adjustment for inflammatory markers (HR=1.30, 95% CI=1.08–1.56).CONCLUSION: CKD is associated with the development of functional impairment independent of comorbidity, body composition, and tests of strength and physical performance. The mechanism may be related to a heightened inflammatory state in CKD.