Association of kidney function with physical performance: the Maastricht study

Abstract

Background: Kidney failure has been associated with decreased physical capacity, although evidence regarding the physical performance of individuals with earlier stages of chronic kidney disease (CKD) remains limited. Methods: Cross-sectional data were derived from the prospective, population-based Maastricht Study. Multivariate linear regression models were fitted to assess the association of estimated glomerular filtration rate (eGFR) and albuminuria categories with physical performance test outcomes. Results: Overall, 7396 participants were included. Compared to eGFR 60–90 ml/min/1.73 m2, values < 60 ml/min/1.73 m2 were associated with significantly shorter 6-min walk distance (β: − 13.04 m, 95% confidence intervals-CI − 19.95; − 6.13), worse timed chair rise stand test time (β: 0.91 s, 95% CI 0.36; 1.47), lower maximal grip (β: − 0.83 kg, 95% CI − 1.50; − 0.15) and elbow flexion (β: − 3.64 Nm, 95% CI − 7.11; − 0.16) strength. Additionally, eGFR > 90 ml/min/1.73 m2 was linked to significantly shorter 6-min walk distance (β: − 6.13 m, 95% CI − 9.44; − 2.82). Urinary albumin excretion > 30 mg/24 h was associated with shorter 6-min walk distance (β: − 12.48 m, 95% CI − 18.28; − 6.68), worse timed chair rise stand test time (β: 0.51 s, 95% CI 0.11; 1.06), lower maximal grip (β: − 1.34 kg, 95% CI − 1.91; − 0.76) and elbow flexion strength (β: − 3.31 Nm, 95% CI − 5.80; − 0.82). Conclusions: Reduced eGFR and higher albuminuria levels were associated with worse physical performance, especially shorter 6-min walk distance and lower muscle strength. The relationship between eGFR and physical function was non-linear, with also high eGFR values being associated with worse performance, especially in the six-minute walk test.