TY - JOUR
T1 - Associations between frailty, physical performance, and renal biomarkers in older people with advanced chronic kidney disease
AU - Smith, George
AU - Avenell, Alison
AU - Band, Margaret M.
AU - Hampson, Geeta
AU - Lamb, Edmund J.
AU - Littleford, Roberta C.
AU - McNamee, Paul
AU - Soiza, Roy L.
AU - Sumukadas, Deepa
AU - Witham, Miles D.
N1 - Funding Information:
We analysed cross-sectional and longitudinal data collected as part of the BiCARB randomised controlled trial [, ], which evaluated the clinical and cost-effectiveness of oral sodium bicarbonate therapy for older patients with advanced CKD and mild metabolic acidosis. The trial was funded by the UK National Institute for Health Research (NIHR) Health Technology Assessment Board (award 10/71/01) and was co-sponsored by the University of Dundee and NHS Tayside (Tayside Academic Health Sciences Collaboration). Ethical approval was granted by the East of Scotland NHS Research Ethics Committee (approval 12/ES/0023) and the trial was approved by the UK Medicines and Healthcare Regulatory Authority (EudraCT number 2011–005,271-16; Clinical Trial Authorisation number 41692/0001/001–0001). The trial was registered at www.isrctn.com (ISRCTN09486651).
Funding Information:
With thanks to the recruiting teams and participants who took part in the BiCARB trial. GS and MDW acknowledge support from the NIHR Newcastle Biomedical Research Centre.
Funding Information:
The BiCARB trial was funded by the National Institute for Health Research Health Technology Assessment programme (project reference 10/71/01). The views expressed are those of the authors and not necessarily those of the NIHR or the Department of Health and Social Care. The Health Services Research Unit and Health Economics Research Unit are core funded by the Chief Scientist Office of the Scottish Government Health and Social Care Directorate.
PY - 2021/10
Y1 - 2021/10
N2 - Purpose: Impaired physical performance and frailty are common in older people with advanced chronic kidney disease but it is unclear which metabolic derangements contribute to these impairments. We, therefore, examined associations between renal biochemical markers and both physical performance and frailty in older people with advanced chronic kidney disease.Methods: Secondary analysis of data from the BiCARB trial, which enrolled non-dialysing patients aged 60 and over, with chronic kidney disease stage 4/5, with serum bicarbonate < 22 mmol/L. Participants undertook the Short Physical Performance Battery, maximum grip strength and six-minute walk test at baseline, 3, 6, 12 and 24 months. Renal biochemistry (serum creatinine, cystatin C, phosphate, and bicarbonate), haemoglobin, 25-hydroxyvitamin D and NT-pro-B-type natriuretic peptide were measured at baseline. Associations between baseline renal biochemistry and physical performance, and between baseline biochemistry and the monthly rate of change in physical performance were assessed.Results: We analysed data from 300 participants (mean age 74 years; 86 [29%] women). 148 (49%) were pre-frail, 86 (29%) were frail. In multivariable cross-sectional baseline analyses, only age and BMI were significantly associated with baseline short physical performance battery; age, sex, body mass index, NT-pro-BNP and 25-hydroxyvitamin D were significantly associated with baseline six-minute walk distance. No significant associations were found between biochemical markers and change in physical performance over time, except between baseline 25-hydroxyvitamin D concentration and change in six-minute walk distance.Conclusions: Biochemical markers associated with chronic kidney disease did not consistently associate with baseline physical performance or the rate of change of physical performance measures.Trial Registration: ISRCTN09486651.
AB - Purpose: Impaired physical performance and frailty are common in older people with advanced chronic kidney disease but it is unclear which metabolic derangements contribute to these impairments. We, therefore, examined associations between renal biochemical markers and both physical performance and frailty in older people with advanced chronic kidney disease.Methods: Secondary analysis of data from the BiCARB trial, which enrolled non-dialysing patients aged 60 and over, with chronic kidney disease stage 4/5, with serum bicarbonate < 22 mmol/L. Participants undertook the Short Physical Performance Battery, maximum grip strength and six-minute walk test at baseline, 3, 6, 12 and 24 months. Renal biochemistry (serum creatinine, cystatin C, phosphate, and bicarbonate), haemoglobin, 25-hydroxyvitamin D and NT-pro-B-type natriuretic peptide were measured at baseline. Associations between baseline renal biochemistry and physical performance, and between baseline biochemistry and the monthly rate of change in physical performance were assessed.Results: We analysed data from 300 participants (mean age 74 years; 86 [29%] women). 148 (49%) were pre-frail, 86 (29%) were frail. In multivariable cross-sectional baseline analyses, only age and BMI were significantly associated with baseline short physical performance battery; age, sex, body mass index, NT-pro-BNP and 25-hydroxyvitamin D were significantly associated with baseline six-minute walk distance. No significant associations were found between biochemical markers and change in physical performance over time, except between baseline 25-hydroxyvitamin D concentration and change in six-minute walk distance.Conclusions: Biochemical markers associated with chronic kidney disease did not consistently associate with baseline physical performance or the rate of change of physical performance measures.Trial Registration: ISRCTN09486651.
KW - s Chronic kidney disease
KW - Biomarkers
KW - Physical performance
KW - Frailty
KW - Chronic kidney disease
UR - http://www.scopus.com/inward/record.url?scp=85102955249&partnerID=8YFLogxK
U2 - 10.1007/s41999-021-00478-4
DO - 10.1007/s41999-021-00478-4
M3 - Article
C2 - 33730363
SN - 1878-7649
VL - 12
SP - 943
EP - 952
JO - European Geriatric Medicine
JF - European Geriatric Medicine
ER -