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Association of Albuminuria and Estimated Glomerular Filtration Rate with Functional Performance Measures in Older Adults with Chronic Kidney Disease. Am J Nephrol 2017;45(2):172-179

Date

01/25/2017

Pubmed ID

28118620

DOI

10.1159/000455388

Abstract

BACKGROUND: Chronic kidney disease (CKD) is increasingly common and disproportionately affects older adults. The contribution of kidney disease to the functional impairment noted in the elderly CKD population is unclear.

METHODS: This is a cross-sectional analysis of a hypertensive cohort of people aged ≥75 years from the Systolic Blood Pressure Intervention Trial. We evaluated estimated glomerular filtration rate (eGFR) and urine albumin-to-creatinine ratio (UACR) as predictors of 3 measures of functional status: EuroQol-5 Dimensional (EQ-5D) score, Falls Efficacy Scale (FES) score, and gait speed. Linear regression models were used to evaluate the associations between our independent variables and outcome measures.

RESULTS: Our analysis included 2,620 participants, mean age of 79.9 (4.0) years. Unadjusted models showed that lower eGFR level and higher UACR level were associated with lower EQ-5D (p < 0.001 for both) and slower gait speed (p < 0.001 for both) and worse scores on FES (p = 0.032 and p = 0.039). In the fully adjusted models, higher levels of UACR remained significantly associated with lower EQ-5D scores and slower gait speed (p = 0.011 and p = 0.002, respectively). In contrast, level of eGFR was not associated with any functional outcome measures when accounting for covariates.

CONCLUSIONS: In individuals aged ≥75 years, albuminuria and eGFR were associated with impairments in physical performance and self-reported functional status; however, only the association with albuminuria remained after adjusting for relevant demographics and comorbidities. Evaluation of albuminuria may provide an additional tool for identifying older individuals at risk for functional impairment.

Author List

Wolfgram DF, Garcia K, Evans G, Zamanian S, Tang R, Wiegmann T, Sharma R, Campbell R, Whittle J, SPRINT Study Research Group

Authors

Jeffrey Whittle MD Professor in the Medicine department at Medical College of Wisconsin
Dawn Felicity Wolfgram MD Associate Professor in the Medicine department at Medical College of Wisconsin




MESH terms used to index this publication - Major topics in bold

Accidental Falls
Activities of Daily Living
Age Factors
Aged
Aged, 80 and over
Albuminuria
Cohort Studies
Comorbidity
Creatinine
Cross-Sectional Studies
Female
Glomerular Filtration Rate
Humans
Hypertension
Kidney Function Tests
Male
Physical Fitness
Prevalence
Renal Insufficiency, Chronic
Self Report
Walking Speed
jenkins-FCD Prod-484 8aa07fc50b7f6d102f3dda2f4c7056ff84294d1d