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BMC Nephrology
Published in: BMC Nephrology 1/2021

Open Access 01-12-2021 | Chronic Kidney Disease | Research article

Association between physical performance and incidence of end-stage renal disease in older adults: a national wide cohort study

Authors: Hee-won Jung, In Young Choi, Dong Wook Shin, Kyungdo Han, Jung Eun Yoo, Sohyun Chun, Yongjin Yi

Published in: BMC Nephrology | Issue 1/2021

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Abstract

Background

Physical frailty has previously been associated with adverse clinical outcomes in patients with end-stage renal disease (ESRD). This study aimed to determine whether impaired physical performance at baseline is associated with the incidence of ESRD, using a nationwide database.

Methods

The timed up-and-go (TUG) test was used to assess physical frailty in 1,552,781 66-year-old individuals, using health examination database records from the Korean National Health Insurance Service. As a primary endpoint, incident ESRD was defined operationally using healthcare claims data from the Korean Health Insurance Review and Assessment Service.

Results

Our results showed that baseline kidney function was significantly worse in individuals with TUG results of > 10 s compared to individuals with an intact TUG performance (≤10 s). Kaplan-Meier analysis showed a stepwise dose-response relationship between baseline physical performance and the incidence rate of ESRD (log-rank test P-value of < 0.001). An increasing ESRD incidence rate trend with poor physical performance remained significant after adjusting for characteristics such as baseline glomerular filtration rate and proteinuria.

Conclusion

Poor baseline physical performance was associated with an increased risk of ESRD, suggesting possible interactions between systemic frailty and vascular aging processes.
Literature
1.
Eckardt KU, Coresh J, Devuyst O, Johnson RJ, Kottgen A, Levey AS, Levin A. Evolving importance of kidney disease: from subspecialty to global health burden. Lancet. 2013;382(9887):158–69.PubMedCrossRef
2.
Webster AC, Nagler EV, Morton RL, Masson P. Chronic kidney disease. Lancet. 2017;389(10075):1238–52.PubMedCrossRef
3.
Kiberd BA, Clase CM. Cumulative risk for developing end-stage renal disease in the US population. J Am Soc Nephrol. 2002;13(6):1635–44.PubMedCrossRef
4.
5.
Rule AD, Semret MH, Amer H, Cornell LD, Taler SJ, Lieske JC, Melton LJ III, Stegall MD, Textor SC, Kremers WK. Association of kidney function and metabolic risk factors with density of glomeruli on renal biopsy samples from living donors. In: Mayo Clinic Proceedings: Elsevier; 2011. p. 282–90.
6.
Kooman JP, Dekker MJ, Usvyat LA, Kotanko P, van der Sande FM, Schalkwijk CG, Shiels PG, Stenvinkel P. Inflammation and premature aging in advanced chronic kidney disease. Am J Physiol Renal Physiol. 2017;313(4):F938–f950.PubMedCrossRef
7.
Stenvinkel P, Larsson TE. Chronic kidney disease: a clinical model of premature aging. Am J Kidney Dis. 2013;62(2):339–51.PubMedCrossRef
8.
Walston J, McBurnie MA, Newman A, Tracy RP, Kop WJ, Hirsch CH, Gottdiener J, Fried LP. Frailty and activation of the inflammation and coagulation systems with and without clinical comorbidities: results from the cardiovascular Health study. Arch Intern Med. 2002;162(20):2333–41.PubMedCrossRef
9.
Fried LP, Tangen CM, Walston J, Newman AB, Hirsch C, Gottdiener J, Seeman T, Tracy R, Kop WJ, Burke G, et al. Frailty in older adults: evidence for a phenotype. J Gerontol A Biol Sci Med Sci. 2001;56(3):M146–56.PubMedCrossRef
10.
Clegg A, Young J, Iliffe S, Rikkert MO, Rockwood K. Frailty in elderly people. Lancet. 2013;381(9868):752–62.PubMedCrossRef
11.
Sikka G, Miller KL, Steppan J, Pandey D, Jung SM, Fraser CD III, Ellis C, Ross D, Vandegaer K, Bedja D. Interleukin 10 knockout frail mice develop cardiac and vascular dysfunction with increased age. Exp Gerontol. 2013;48(2):128–35.PubMedCrossRef
12.
Walston J, Fedarko N, Yang H, Leng S, Beamer B, Espinoza S, Lipton A, Zheng H, Becker K. The physical and biological characterization of a frail mouse model. J Gerontol Ser A Biol Med Sci. 2008;63(4):391–8.CrossRef
13.
Jung HW, Kim SW, Yoon SJ, Choi JY, Kim KI, Kim CH. Associations between frailty, retinal microvascular changes, and cerebral white matter abnormalities in Korean older adults. J Am Geriatr Soc. 2014;62(11):2209–10.PubMedCrossRef
14.
Baker DJ, Wijshake T, Tchkonia T, LeBrasseur NK, Childs BG, Van De Sluis B, Kirkland JL, van Deursen JM. Clearance of p16 Ink4a-positive senescent cells delays ageing-associated disorders. Nature. 2011;479(7372):232.PubMedPubMedCentralCrossRef
15.
Baker DJ, Childs BG, Durik M, Wijers ME, Sieben CJ, Zhong J, Saltness RA, Jeganathan KB, Verzosa GC, Pezeshki A. Naturally occurring p16 Ink4a-positive cells shorten healthy lifespan. Nature. 2016;530(7589):184.PubMedPubMedCentralCrossRef
16.
McAdams-DeMarco MA, Law A, Salter ML, Boyarsky B, Gimenez L, Jaar BG, Walston JD, Segev DL. Frailty as a novel predictor of mortality and hospitalization in individuals of all ages undergoing hemodialysis. J Am Geriatr Soc. 2013;61(6):896–901.PubMedPubMedCentralCrossRef
17.
McAdams-DeMarco MA, Ying H, Olorundare I, King EA, Haugen C, Buta B, Gross AL, Kalyani R, Desai NM, Dagher NN, et al. Individual frailty components and mortality in kidney transplant recipients. Transplantation. 2017;101(9):2126–32.PubMedPubMedCentralCrossRef
18.
Lee SW, Lee A, Yu M-Y, Kim SW, Kim KI, Na KY, Chae DW, Chin HJ. Is frailty a modifiable risk factor of future adverse outcomes in elderly patients with incident end-stage renal disease? J Korean Med Sci. 2017;32(11):1800–6.PubMedPubMedCentralCrossRef
19.
McAdams-DeMarco MA, Law A, Salter ML, Chow E, Grams M, Walston J, Segev DL. Frailty and early hospital readmission after kidney transplantation. Am J Transplant. 2013;13(8):2091–5.PubMedPubMedCentralCrossRef
20.
Kim HS, Shin DW, Lee WC, Kim YT, Cho B. National screening program for transitional ages in Korea: a new screening for strengthening primary prevention and follow-up care. J Korean Med Sci. 2012;27(Suppl):S70–5.PubMedPubMedCentralCrossRef
21.
von Haehling S, Morley JE, Coats AJ, Anker SD. Ethical guidelines for publishing in the journal of Cachexia, sarcopenia and muscle: update 2019. J Cachexia Sarcopenia Muscle. 2019;10(5):1143–5.CrossRef
22.
Podsiadlo D, Richardson S. The timed “up & go”: a test of basic functional mobility for frail elderly persons. J Am Geriatr Soc. 1991;39(2):142–8.PubMedCrossRef
23.
Savva GM, Donoghue OA, Horgan F, O’regan C, Cronin H, Kenny RA. Using timed up-and-go to identify frail members of the older population. J Gerontol A Biol Sci Med Sci. 2012;68(4):441–6.PubMedCrossRef
24.
Jung H-W, Kim S, Jang I-Y, Shin DW, Lee JE, Won CW. Screening value of timed up and go test for frailty and low physical performance in Korean older population: the Korean frailty and aging cohort study (KFACS). Ann Geriat Med Res. 2020;24(4):259.CrossRef
25.
Levey AS, Coresh J, Greene T, Stevens LA, Zhang YL, Hendriksen S, Kusek JW, Van Lente F. Using standardized serum creatinine values in the modification of diet in renal disease study equation for estimating glomerular filtration rate. Ann Intern Med. 2006;145(4):247–54.PubMedCrossRef
26.
Levey AS, Stevens LA, Schmid CH, Zhang YL, Castro AF 3rd, Feldman HI, Kusek JW, Eggers P, Van Lente F, Greene T, et al. A new equation to estimate glomerular filtration rate. Ann Intern Med. 2009;150(9):604–12.PubMedPubMedCentralCrossRef
27.
Fine JP, Gray RJ. A proportional hazards model for the subdistribution of a competing risk. J Am Stat Assoc. 1999;94(446):496–509.CrossRef
28.
Franceschi C, Campisi J. Chronic inflammation (inflammaging) and its potential contribution to age-associated diseases. J Gerontol A Biol Sci Med Sci. 2014;69(Suppl 1):S4–9.PubMedCrossRef
29.
Vel Szic KS, Declerck K, Vidaković M, Berghe WV. From inflammaging to healthy aging by dietary lifestyle choices: is epigenetics the key to personalized nutrition? Clin Epigenetics. 2015;7(1):33.PubMedCentralCrossRef
30.
Yaffe K, Kanaya A, Lindquist K, Simonsick EM, Harris T, Shorr RI, Tylavsky FA, Newman AB. The metabolic syndrome, inflammation, and risk of cognitive decline. JAMA. 2004;292(18):2237–42.PubMedCrossRef
31.
Hawkins MS, Sevick MA, Richardson CR, Fried LF, Arena VC, Kriska AM. Association between physical activity and kidney function: National Health and nutrition examination survey. Med Sci Sports Exerc. 2011;43(8):1457–64.PubMedCrossRef
32.
Jung HW, Kim KI. Multimorbidity in older adults. J Korean Geriatr Soc. 2014;18(2):65–71.CrossRef
33.
Ballew SH, Chen Y, Daya NR, Godino JG, Windham BG, McAdams-DeMarco M, Coresh J, Selvin E, Grams ME. Frailty, kidney function, and polypharmacy: the atherosclerosis risk in communities (ARIC) study. Am J Kidney Dis. 2017;69(2):228–36.PubMedCrossRef
34.
Sutaria A, Liu L, Ahmed Z. Multiple medication (polypharmacy) and chronic kidney disease in patients aged 60 and older: a pharmacoepidemiologic perspective. Ther Adv Cardiovasc Dis. 2016;10(4):242–50.PubMedPubMedCentralCrossRef
35.
Rosario BL, Rosso AL, Aizenstein HJ, Harris T, Newman AB, Satterfield S, Studenski SA, Yaffe K, Rosano C, Health ABCS. Cerebral white matter and slow gait: contribution of Hyperintensities and Normal-appearing parenchyma. J Gerontol A Biol Sci Med Sci. 2016;71(7):968–73.PubMedPubMedCentralCrossRef
36.
Reese PP, Cappola AR, Shults J, Townsend RR, Gadegbeku CA, Anderson C, Baker JF, Carlow D, Sulik MJ, Lo JC, et al. Physical performance and frailty in chronic kidney disease. Am J Nephrol. 2013;38(4):307–15.PubMedCrossRef
37.
Jang I-Y, Jung H-W, Park H, Lee CK, Yu SS, Lee YS, Lee E, Glynn RJ, Kim DH. A multicomponent frailty intervention for socioeconomically vulnerable older adults: a designed-delay study. Clin Interv Aging. 2018; In press.
38.
Cesari M, Vellas B, Hsu F-C, Newman AB, Doss H, King AC, Manini TM, Church T, Gill TM, Miller ME. A physical activity intervention to treat the frailty syndrome in older persons—results from the LIFE-P study. J Gerontol A Biol Sci Med Sci. 2014;70(2):216–22.PubMedPubMedCentralCrossRef
39.
Cameron ID, Fairhall N, Langron C, Lockwood K, Monaghan N, Aggar C, Sherrington C, Lord SR, Kurrle SE. A multifactorial interdisciplinary intervention reduces frailty in older people: randomized trial. BMC Med. 2013;11:65.PubMedPubMedCentralCrossRef
40.
Montero-Odasso M, Almeida QJ, Bherer L, Burhan AM, Camicioli R, Doyon J, Fraser S, Muir-Hunter S, Li KZH, Liu-Ambrose T, et al. Consensus on shared measures of mobility and cognition: from the Canadian consortium on Neurodegeneration in aging (CCNA). J Gerontol A Biol Sci Med Sci. 2019;74(6):897–909.PubMedCrossRef
41.
Cruz-Jentoft AJ, Bahat G, Bauer J, Boirie Y, Bruyère O, Cederholm T, Cooper C, Landi F, Rolland Y, Sayer AA, et al. Sarcopenia: revised European consensus on definition and diagnosis. Age Ageing. 2018;48:16–31.PubMedCentralCrossRef
42.
Bischoff HA, Stahelin HB, Monsch AU, Iversen MD, Weyh A, von Dechend M, Akos R, Conzelmann M, Dick W, Theiler R. Identifying a cut-off point for normal mobility: a comparison of the timed ‘up and go’ test in community-dwelling and institutionalised elderly women. Age Ageing. 2003;32(3):315–20.PubMedCrossRef
43.
S-w K, Jung H-W, Kim C-H, K-i K, Chin HJ, Lee H. A new equation to estimate muscle mass from creatinine and cystatin C. PLoS One. 2016;11(2):e0148495.CrossRef
44.
Baxmann AC, Ahmed MS, Marques NC, Menon VB, Pereira AB, Kirsztajn GM, Heilberg IP. Influence of muscle mass and physical activity on serum and urinary creatinine and serum cystatin C. Clin J Am Soc Nephrol. 2008;3(2):348–54.PubMedPubMedCentralCrossRef
Metadata
Title
Association between physical performance and incidence of end-stage renal disease in older adults: a national wide cohort study
Authors
Hee-won Jung
In Young Choi
Dong Wook Shin
Kyungdo Han
Jung Eun Yoo
Sohyun Chun
Yongjin Yi
Publication date
01-12-2021
Publisher
BioMed Central
Published in
BMC Nephrology / Issue 1/2021
Electronic ISSN: 1471-2369
DOI
https://doi.org/10.1186/s12882-021-02291-4

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