Associations between frailty, physical performance, and renal biomarkers in older people with advanced chronic kidney disease

George Smith,Roberta C Littleford,Deepa Sumukadas,Alison Avenell,Roy L Soiza,Margaret M Band,Geeta Hampson,Edmund J Lamb,Paul Mcnamee,Miles D Witham

doi:10.1007/s41999-021-00478-4

Abstract

Key summary pointsAimTo test whether renal biochemical markers were associated with physical performance and frailty in older people with advanced chronic kidney disease.FindingsBiochemical markers associated with chronic kidney disease did not consistently associate with baseline physical performance or the rate of change of physical performance measures.MessageTargeting improvements in renal biochemistry may not be a fruitful way to improve physical function and frailty in older people with advanced chronic kidney disease.

Highlights

Frailty is a state of impaired homeostasis and reduced physiological reserve such that a minor stressor event causes a disproportionately large decline in health status [1]
Biochemical markers associated with chronic kidney disease did not consistently associate with baseline physical performance or the rate of change of physical performance measures
Impaired physical performance is a key component of the physical frailty syndrome, and measures of physical performance feature in the frailty phenotype described by Fried et al [5] along with weight loss, exhaustion and low physical activity levels

Summary

Introduction

Frailty is a state of impaired homeostasis and reduced physiological reserve such that a minor stressor event causes a disproportionately large decline in health status [1]. Several pathophysiological processes that are present in CKD could plausibly affect skeletal muscle function, leading to impaired physical performance and physical frailty These include but are not limited to: reduction of food intake ( protein), persistent inflammation, oxidative stress, metabolic acidosis, anaemia, impaired vitamin D metabolism, vascular dysfunction, uraemia, and hyperphosphataemia [10,11,12]. These factors, together with the high prevalence of multimorbid disease that accompanies CKD [13], may all play a part in driving the high prevalence of frailty seen in patients with CKD

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