Kidney Week

Abstract: TH-PO955

Decrements in Lower-Body Muscle Power Are Associated with Impaired Physical Function in Patients on Hemodialysis

Session Information

• Physical Activity and Lifestyle in Kidney Diseases
  October 24, 2024 | Location: Exhibit Hall, Convention Center
  Abstract Time: 10:00 AM - 12:00 PM

Category: Health Maintenance, Nutrition, and Metabolism

• 1500 Health Maintenance, Nutrition, and Metabolism

Authors

• Macheret, Natalie Ann, Wake Forest University, Winston-Salem, North Carolina, United States

Natalie Ann Macheret

• Dillman, Drake, Indiana University School of Medicine, Indianapolis, Indiana, United States

Drake Dillman, MS

• Moe, Sharon M., Indiana University School of Medicine, Indianapolis, Indiana, United States

Sharon M. Moe, MD, FASN

• Karp, Sharon L., Indiana University School of Medicine, Indianapolis, Indiana, United States

Sharon L. Karp, MD, MPH

• Lim, Kenneth, Indiana University School of Medicine, Indianapolis, Indiana, United States

Kenneth Lim, MD, PhD, FASN

• Arroyo, Eliott, Wake Forest University, Winston-Salem, North Carolina, United States

Eliott Arroyo, PhD

Background

Patients with chronic kidney disease (CKD) commonly suffer from poor physical function and decreased quality of life. Muscular power—the product of force and velocity of contraction—is a significant predictor of physical function in healthy older adults. However, the role of muscle power in regulating physical function in CKD is unclear. Herein, we sought to examine the relationship between muscular power and physical function in individuals with advanced CKD on hemodialysis (HD).

Methods

This cross-sectional study used data from the Musculoskeletal Function, Imaging and Tissue Resource Core (FIT Core) study cohort at the Indiana Center for Musculoskeletal Health. Participants completed a comprehensive battery of objective and self-reported physical function assessments. Muscle power was estimated from the sit-to-stand test using a validated equation and adjusted for body mass (relative power) and leg muscle mass (specific power). Multiple linear regression analysis was used to assess the association between relative muscle power and physical function outcomes.

Results

Group comparisons between patients on HD (n=44, 54.5% men, age=50±14 y) and healthy controls (n=50, 62% men, age=52±14 y) showed that the HD group had a greater prevalence of diabetes (p<0.001), but no significant differences in age, sex, or race. Patients on HD exhibited significant decrements in both relative (3.0 [0.8] W/kg versus 3.9 [1.2] W/kg in controls; p<0.001) and specific (14.5 [3.4] W/kg versus 17.8 [5.3]; p<0.001) muscle power, even after adjusting for age, sex, diabetes, smoking status, cardiovascular disease, and race. Relative muscle power in patients on HD was significantly associated with the short physical performance battery (SPPB) score (β=1.5, p<0.001) and with the physical function subscale of the Short Form 36 Health Survey (SF36 PF-10) score (β=13.0,p=0.006) after adjusting for covariates.

Conclusion

Patients on HD exhibit significant decrements in both relative and specific lower body muscle power, which indicates that these decrements are not a result of muscle atrophy alone. The decline in muscle power is independently associated with both objective and self-reported measures of physical function. Further research is needed to validate the prognostic utility of muscle power in patients on HD.

Funding

• Other NIH Support