Slow pace linked to early death in kidney disease patients

Washington: Slow walking speed, a trait common in diabetics and others with chronic kidney disease, is strongly associated with early death, according to a new study.

To study the issue, Baback Roshanravan, MD MS (Kidney Research Institute, Division of Nephrology at the University of Washington) and his colleagues followed 385 patients with CKD without a history of stroke or disability and with an average age of 61 years. The researchers compared handgrip strength, usual walking speed, six-minute walking distance, and timed up and go (the time that a person takes to rise from a chair, walk four meters, turn around, walk back to the chair, and sit down). Among the major findings during the average three-year follow-up period: Measures of lower extremity performance were at least 30 percent lower than predicted, but handgrip strength was relatively preserved. Each 0.1-meter per second slower walking speed was linked with a 26 percent higher risk for death over an average three-year follow-up period, and each one-second longer timed up and go was linked with an 8 percent higher risk for death. Walking speed and timed up and go more strongly predicted three-year mortality than kidney function or common blood tests. Adding walking speed to common laboratory tests of kidney function significantly improved the prediction of three-year mortality. The results indicate that impaired physical performance of the lower extremities is common in CKD and is strongly linked with premature death. "Our findings suggest that lower extremity physical performance testing in chronic kidney disease patients may help identify those individuals who are more burdened by their chronic kidney disease," said Dr. Roshanravan. The study has been published in the Journal of the American Society of Nephrology (JASN). ANI