P3419Low renal function is associated with poor physical function and exercise capacity in patients with chronic cardiovascular disease

Abstract

Background: Poor physical function and exercise capacity are strongly associated with an increased risk for cardiovascular events and mortality in patients with cardiovascular disease (CVD). Although several studies have reported that low renal function decreases physical function and exercise capacity in elderly people and patients with acute CVD or chronic kidney disease, few studies have addressed the relationship between renal function and physical function including exercise capacity in patients with chronic CVD. Purpose: To examine the association between estimated glomerular filtration rate (eGFR) as a parameter of renal function and physical function in patients with chronic CVD. Methods: We recruited 372 outpatients with chronic CVD with New York Heart Association functional classification class 1-2. We evaluated 356 patients after excluding those with eGFR (mL/min/1.73 m2) <30, hemodialytic patients, or those who needed assistance for walking. Blood hemoglobin, albumin, and brain natriuretic peptide (BNP) were measured and patient' characteristics including age, sex, body mass index (BMI), comorbidity, eGFR, and left ventricular ejection fraction (LVEF) were assessed. We also measured handgrip strength, quadriceps isometric strength (QIS), walking velocity, and one leg standing (OLS) time as parameters of physical function, and 6-min walk distance (6MWD) as a parameter of exercise capacity. The 356 patients were divided in three groups according to eGFR: 30-45; 45-60; and >60. We compared all parameters of physical function and exercise capacity among the three groups. Results: The study population consisted of 356 patients with mean age of 72.0±8.4 years and 74.4% of males. With regard to cardiovascular diseases, 44.3% had angina pectoris, 44.6% had old myocardial infraction, and 42.9% had compensated heart failure. Lower eGFR values were associated with weaker handgrip strength and QIS, slower walking velocity, and shorter OLS time and 6MWD (p for trend <0.001). After adjusting for age, sex, BMI, comorbidity, haemoglobin, albumin, BNP, and LVEF, patients with eGFR 30-45 had shorter OLS time (adjusted mean: 21.9 s vs. 41.9 s; p<0.001) and 6MWD (adjusted mean: 454 m vs. 517 m; p<0.001), and slower walking velocity (adjusted mean: 1.4 m/s vs. 1.8 m/s; p<0.001) compared with those with eGFR >60. There were no significant differences in handgrip strength and QIS. Conclusion: Low renal function was associated with poor physical function and exercise capacity in patients with chronic CVD. (Table Presented).