Estimated GFR, Albuminuria, and Physical Function: The Brain in Kidney Disease (BRINK) Cohort StudyPlain-Language Summary
Rationale & Objective: Chronic kidney disease (CKD) is associated with impaired physical performance. However, the association between albuminuria, a marker of vascular endothelial dysfunction, and physical performance has not been fully characterized. We hypothesized that estimated glomerul...
| Main Authors: | , , , , |
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| Format: | Article |
| Language: | English |
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Elsevier
2022-10-01
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| Series: | Kidney Medicine |
| Subjects: | |
| Online Access: | http://www.sciencedirect.com/science/article/pii/S2590059522001534 |
| _version_ | 1797995989189001216 |
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| author | Ryan Mello Kirsten L. Johansen Anne Murray Cynthia Davey Allyson Hart |
| author_facet | Ryan Mello Kirsten L. Johansen Anne Murray Cynthia Davey Allyson Hart |
| author_sort | Ryan Mello |
| collection | DOAJ |
| description | Rationale & Objective: Chronic kidney disease (CKD) is associated with impaired physical performance. However, the association between albuminuria, a marker of vascular endothelial dysfunction, and physical performance has not been fully characterized. We hypothesized that estimated glomerular filtration rate (eGFR) and albuminuria would be independently associated with physical performance. Study Design: Cross-sectional analysis. Setting & Participants: A total of 571 adults with and without CKD. Predictors: Creatinine-based eGFR (eGFRCr) and cystatin C-based eGFR (eGFRCysC) and urine albumin to creatinine ratio (UACR). Outcome: Short Physical Performance Battery (SPPB). Analytical Approach: Univariate and multivariable logistic regression models were used to examine associations of eGFR and UACR with impaired physical performance. Results: Of the 571 participants (mean age, 69.3 years), 157 (27.5%) had eGFRCr (mL/min/1.73m2) <30, 276 (48.3%) had eGFRCr 30-<60, and 138 (24.2%) had eGFRCr ≥60; 303 (55.3%) participants had eGFRcysC <30, 141 (25.7%) had eGFRcysC 30-<60, and 104 (19.0%) had eGFRcysC ≥60. Impaired physical performance was observed in 222 (38.9%) participants. Separate univariate analyses showed that lower eGFRCr, lower eGFRCysC, and higher UACR were associated with higher odds of impaired physical performance. In the adjusted model with eGFRCr or eGFRCysC, UACR, and covariates, UACR retained a statistically significant association with impaired physical performance (adjusted odds ratio [OR], 2.04; 95% confidence interval [CI], 1.21-3.47 for UACR from 30-300 mg/g vs <30 mg/g and adjusted OR, 1.93; 95% CI, 1.01-3.69 for UACR >300 mg/g vs <30 mg/g), but eGFRCr and eGFRCysC did not. Limitations: Cross-sectional analysis, estimated rather than measured GFR. Conclusions: Only UACR was associated with worse physical performance in the fully adjusted model, suggesting that vascular endothelial function and inflammation may be important mechanisms of decreased physical function. Similar results were found using eGFRCr or eGFRCysC, suggesting that confounding based on muscle mass does not explain the lack of an association between eGFRCr and physical performance. |
| first_indexed | 2024-04-11T10:10:17Z |
| format | Article |
| id | doaj.art-203077869a564482a8541abc14f5c4b0 |
| institution | Directory Open Access Journal |
| issn | 2590-0595 |
| language | English |
| last_indexed | 2024-04-11T10:10:17Z |
| publishDate | 2022-10-01 |
| publisher | Elsevier |
| record_format | Article |
| series | Kidney Medicine |
| spelling | doaj.art-203077869a564482a8541abc14f5c4b02022-12-22T04:30:07ZengElsevierKidney Medicine2590-05952022-10-01410100531Estimated GFR, Albuminuria, and Physical Function: The Brain in Kidney Disease (BRINK) Cohort StudyPlain-Language SummaryRyan Mello0Kirsten L. Johansen1Anne Murray2Cynthia Davey3Allyson Hart4Nephrology Division, Department of Medicine, Hennepin Healthcare, Minneapolis, MNNephrology Division, Department of Medicine, Hennepin Healthcare, Minneapolis, MN; Chronic Disease Research Group, Hennepin Healthcare Research Institute, Minneapolis, MN; Berman Center for Outcomes and Clinical Research, Hennepin Healthcare Research Institute, Minneapolis, MNBerman Center for Outcomes and Clinical Research, Hennepin Healthcare Research Institute, Minneapolis, MN; Geriatrics Division, Department of Medicine, Hennepin Healthcare, Minneapolis, MNBiostatistical Design and Analysis Center, Clinical and Translational Science Institute, University of Minnesota, Minneapolis, MNNephrology Division, Department of Medicine, Hennepin Healthcare, Minneapolis, MN; Chronic Disease Research Group, Hennepin Healthcare Research Institute, Minneapolis, MN; Address for Correspondence: Allyson Hart, MD, MSc, Hennepin Healthcare, 701 Park Ave, Nephrology Ste S5, Minneapolis, MN 55415.Rationale & Objective: Chronic kidney disease (CKD) is associated with impaired physical performance. However, the association between albuminuria, a marker of vascular endothelial dysfunction, and physical performance has not been fully characterized. We hypothesized that estimated glomerular filtration rate (eGFR) and albuminuria would be independently associated with physical performance. Study Design: Cross-sectional analysis. Setting & Participants: A total of 571 adults with and without CKD. Predictors: Creatinine-based eGFR (eGFRCr) and cystatin C-based eGFR (eGFRCysC) and urine albumin to creatinine ratio (UACR). Outcome: Short Physical Performance Battery (SPPB). Analytical Approach: Univariate and multivariable logistic regression models were used to examine associations of eGFR and UACR with impaired physical performance. Results: Of the 571 participants (mean age, 69.3 years), 157 (27.5%) had eGFRCr (mL/min/1.73m2) <30, 276 (48.3%) had eGFRCr 30-<60, and 138 (24.2%) had eGFRCr ≥60; 303 (55.3%) participants had eGFRcysC <30, 141 (25.7%) had eGFRcysC 30-<60, and 104 (19.0%) had eGFRcysC ≥60. Impaired physical performance was observed in 222 (38.9%) participants. Separate univariate analyses showed that lower eGFRCr, lower eGFRCysC, and higher UACR were associated with higher odds of impaired physical performance. In the adjusted model with eGFRCr or eGFRCysC, UACR, and covariates, UACR retained a statistically significant association with impaired physical performance (adjusted odds ratio [OR], 2.04; 95% confidence interval [CI], 1.21-3.47 for UACR from 30-300 mg/g vs <30 mg/g and adjusted OR, 1.93; 95% CI, 1.01-3.69 for UACR >300 mg/g vs <30 mg/g), but eGFRCr and eGFRCysC did not. Limitations: Cross-sectional analysis, estimated rather than measured GFR. Conclusions: Only UACR was associated with worse physical performance in the fully adjusted model, suggesting that vascular endothelial function and inflammation may be important mechanisms of decreased physical function. Similar results were found using eGFRCr or eGFRCysC, suggesting that confounding based on muscle mass does not explain the lack of an association between eGFRCr and physical performance.http://www.sciencedirect.com/science/article/pii/S2590059522001534AlbuminuriaeGFRphysical performancefrailtyCKD |
| spellingShingle | Ryan Mello Kirsten L. Johansen Anne Murray Cynthia Davey Allyson Hart Estimated GFR, Albuminuria, and Physical Function: The Brain in Kidney Disease (BRINK) Cohort StudyPlain-Language Summary Kidney Medicine Albuminuria eGFR physical performance frailty CKD |
| title | Estimated GFR, Albuminuria, and Physical Function: The Brain in Kidney Disease (BRINK) Cohort StudyPlain-Language Summary |
| title_full | Estimated GFR, Albuminuria, and Physical Function: The Brain in Kidney Disease (BRINK) Cohort StudyPlain-Language Summary |
| title_fullStr | Estimated GFR, Albuminuria, and Physical Function: The Brain in Kidney Disease (BRINK) Cohort StudyPlain-Language Summary |
| title_full_unstemmed | Estimated GFR, Albuminuria, and Physical Function: The Brain in Kidney Disease (BRINK) Cohort StudyPlain-Language Summary |
| title_short | Estimated GFR, Albuminuria, and Physical Function: The Brain in Kidney Disease (BRINK) Cohort StudyPlain-Language Summary |
| title_sort | estimated gfr albuminuria and physical function the brain in kidney disease brink cohort studyplain language summary |
| topic | Albuminuria eGFR physical performance frailty CKD |
| url | http://www.sciencedirect.com/science/article/pii/S2590059522001534 |
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