Relación entre la función física autoinformada basal y longitudinal y los resultados cardiorrenales en la ERC:...

Physical function is essential for independent living and good health. The trajectory of physical function and its association with important clinical outcomes is understudied in chronic kidney disease (CKD). We aimed to describe the associations of baseline and longitudinal self-reported physical function with cardiorenal outcomes among individuals with CKD.

Prospective cohort study.

Participants of the multicenter Chronic Renal Insufficiency Cohort (CRIC) study.

Physical Component Summary (PCS) score and PCS slope.

Incident heart failure (HF), incident end-stage kidney disease (ESKD), and all-cause mortality.

Multivariable adjusted Cox regression models examined associations of baseline PCS score with outcomes, and in separate models, assessed associations of PCS slope with outcomes. Effect modification was assessed by age, sex, race, and eGFR groups.

Lower baseline PCS scores (per 10-points) were independently associated with higher risks of incident HF (HR 1.21, 95% CI 1.11-1.32) and all-cause mortality (HR 1.21, 1.16-1.26), but not with incident ESKD (HR 0.98, 0.93-1.04). PCS change (per 4-point annually) was also independently associated with higher risks for all three outcomes (incident HF [HR 1.22, 1.05-1.42]; all-cause mortality [HR 1.22, 1.13-1.32]; and incident ESKD [HR 1.11, 1.01-1.22]).

Residual confounding, selection bias, and linearity assumption.

Among individuals with CKD, baseline self-reported physical function was significantly associated with increased risk of incident HF and mortality after full adjustment. In addition, longitudinal changes in self-reported physical function were associated with incident HF, incident ESKD and mortality, even after accounting for baseline self-reported physical function. These findings support monitoring for and testing of early interventions to preserve physical function and potentially prevent or delay adverse outcomes.