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Decline in measured glomerular filtration rate is associated with a decrease in endurance, strength, balance and fine

Matthias Hellberg1, Peter Höglund2, Philippa Svensson1

  • 1Department of Nephrology, Faculty of Medicine, Lund University, Institution of Clinical Sciences, Lund, Sweden.

Nephrology (Carlton, Vic.)
|May 11, 2016
PubMed
Summary

Physical performance declines in chronic kidney disease (CKD) and is linked to kidney function. Impaired walking, strength, balance, and fine motor skills in CKD patients correlate with reduced glomerular filtration rate (GFR).

Keywords:
balanceendurancefine motor skillsglomerular filtration ratephysical performancestrength

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Area of Science:

  • Nephrology
  • Geriatrics
  • Physical Medicine

Background:

  • Physical performance is crucial for morbidity and mortality in chronic kidney disease (CKD).
  • Understanding the relationship between physical function and declining kidney function is vital for patient management.

Purpose of the Study:

  • To identify key physical performance measures in CKD patients.
  • To investigate associations between these measures and declining glomerular filtration rate (GFR).

Main Methods:

  • Assessed endurance (6-min walk test, stair climbing), muscular endurance (sit-to-stand, heel/toe raises), strength (quadriceps, handgrip), balance (functional reach, Berg's scale), and fine motor skills (Moberg's test).
  • Measured GFR using Iohexol clearance in 101 CKD patients (stages 3b-5) not on dialysis.

Main Results:

  • All physical performance measures were impaired in CKD patients.
  • A 10 mL/min/1.73 m² decrease in GFR correlated with a 35m shorter 6-min walk distance.
  • Declining GFR was significantly associated with reduced walking capacity, isometric quadriceps strength, balance (functional reach), and fine motor skills (Moberg's test), particularly in the left extremities.

Conclusions:

  • CKD patients exhibit impairments in endurance, muscular endurance, strength, balance, and fine motor skills.
  • Walking capacity, quadriceps strength, balance, and fine motor skills are linked to GFR decline.
  • Left extremities appear more sensitive to GFR changes, aging, and comorbidities in CKD.