Kidney Week

Abstract: SA-PO1070

Baseline and Longitudinal Self-Reported Physical Function and Important Clinical Outcomes in CKD

Session Information

• CKD: Epidemiology, Risk Factors, and Prevention - 3
  October 26, 2024 | Location: Exhibit Hall, Convention Center
  Abstract Time: 10:00 AM - 12:00 PM

Category: CKD (Non-Dialysis)

• 2301 CKD (Non-Dialysis): Epidemiology, Risk Factors, and Prevention

Authors

• Schrauben, Sarah J., University of Pennsylvania Perelman School of Medicine, Philadelphia, Pennsylvania, United States

Sarah J. Schrauben, MD, MS

• Peschard, Vanessa-Giselle, San Francisco VA Health Care System, San Francisco, California, United States

Vanessa-Giselle Peschard, MD, MA, MS, MSc

• Brown, Rebecca T., University of Pennsylvania Perelman School of Medicine, Philadelphia, Pennsylvania, United States

Rebecca T. Brown, MD, MPH

• Zhang, Xiaoming, University of Pennsylvania Perelman School of Medicine, Philadelphia, Pennsylvania, United States

Xiaoming Zhang

• Shlipak, Michael, San Francisco VA Health Care System, San Francisco, California, United States

Michael Shlipak, MD, MPH

• Tangri, Navdeep, University of Manitoba Max Rady College of Medicine, Winnipeg, Manitoba, Canada

Navdeep Tangri, MD, PhD

• Yang, Wei, University of Pennsylvania Perelman School of Medicine, Philadelphia, Pennsylvania, United States

Wei Yang, PhD

Background

Physical function is essential for independent living and good health. However, it’s evolution and association with important clinical outcomes is unknown among people with CKD. We aimed to describe self-reported physical function over time and its relationship to heart failure events, incident end-stage kidney disease (ESKD), and death in a CKD cohort.

Methods

Using annual data from the prospective CRIC Study, we calculated the physical composite summary (PCS) score from the SF-12 survey, a validated summary measure of physical health (range, 0-100, higher scores indicate better function). Linear regression models were used to calculate yearly PCS change for each participant using annual PCS scores from baseline to year 3 visits. After the year 3 visit, Cox models were used to examine the association of baseline PCS score and yearly PCS change with incident heart failure, incident ESKD and death. We also assessed effect modification by age, sex, race, and eGFR groups.

Results

Among 5,495 CRIC participants at baseline, mean age was 60 yrs, 42.7% were non-Hispanic Black, 51.5% had diabetes and mean eGFR was 48.1 ml/min/1.73². Median (IQR) follow up was 9.4 (7.6-16.8) yrs. Mean (SD) PCS yearly change in the first 3 yrs was -0.17 (3.99). Lower baseline PCS and declining PCS slope were associated with 20-29% increased risk of incident heart failure and death and declining PCS slope was associated with 11% increased risk of incident ESKD (Table). Interactions were found for PCS-12 slope decline between eGFR groups and incident heart failure (HR for eGFR ≥30: 1.21, 95% CI: 1.05-1.39; HR for eGFR <30: 0.82, 95% CI: 0.61-1.09), and between race groups and ESKD (HR for Non-Hispanic White group: 1.09, 95% CI: 0.91-1.31; HR for Non-Hispanic Black group: 0.99, 95% CI: 0.87-1.13; HR for Hispanic group: 1.45, 95% CI: 1.09-1.93).

Conclusion

Baseline and longitudinal changes in self-reported physical function were associated with important clinical outcomes in CKD, highlighting the importance of monitoring self-reported physical function over time in CKD care to identify those at risk and who may benefit from early and targeted interventions.

Funding

• NIDDK Support