Abstract
BackgroundPhysical 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.MethodsThe 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.ResultsOur 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.ConclusionPoor baseline physical performance was associated with an increased risk of ESRD, suggesting possible interactions between systemic frailty and vascular aging processes.
Highlights
Physical frailty has previously been associated with adverse clinical outcomes in patients with endstage renal disease (ESRD)
This study aimed to determine whether physical frailty measured using the timed ‘up-and-go’ (TUG) test at baseline was associated with the incidence of ESRD in Korean older adults aged 66 years who had participated in the National Screening Program for Transitional Ages (NSPTA)
The NSPTA is a special part of the national health screening program for 66-year-old individuals that includes a geriatric assessment [20] in the National Health Screening Program (NHSP), which is provided by the Korean National Health Insurance Service (KNHIS)
Summary
Physical frailty has previously been associated with adverse clinical outcomes in patients with endstage renal disease (ESRD). The causes of CKD vary considerably; chronic diseases such as DM and HT have been reported to be main causes of CKD in high- and middle-income countries [2] These chronic diseases and metabolic risk factors, such as cigarette smoking and obesity, have been reported to be factors promoting glomerulosclerosis, which eventually leads to decreased kidney function [5]. Recent studies have suggested that reducing systemic inflammation associated with aging, both in an accelerated aging mice model and in naturally aged mice, can lead to an improvement in frailty in rodents [14, 15]. These results suggest that frailty is a biological construct that may reflect the systemic aging status of organisms
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