Decline in measured glomerular filtration rate is associated with a decrease in endurance, strength, balance and fine motor skills.
AIM
Physical performance in chronic kidney disease affects morbidity and mortality. The aim was to find out which measures of physical performance are important in chronic kidney disease (CKD) and if there are associations with declining measured glomerular filtration rate (GFR).


METHODS
Endurance was assessed by 6 min walk test (6-MWT) and stair climbing, muscular endurance by 30 s sit to stand, heel rises and toe lifts, strength by quadriceps- and handgrip-strength, balance by functional reach and Berg's balance scale, and fine motor skills by Moberg's picking-up test. GFR was measured by Iohexol clearance.


RESULTS
The study comprised 101 patients with CKD 3b-5 not started dialysis, 40 women and 61 men, with a mean age of 67 ± 13 (range: 22 - 87) years. All measures of physical performance were impaired. A decrease in GFR of 10 mL/min per 1.73 m2 corresponded to a 35 metre shorter walking distance in the 6-MWT. Multivariable linear regression analysis showed significant relationships between decline in GFR and the 6-MWT (P = 0.04), isometric quadriceps strength left (P = 0.04), balance measured as functional reach (P = 0.02) and fine motor skills in the left hand as measured by Moberg's picking-up test (P = 0.01), respectively, after sex, age, comorbidity and the interaction between sex and age had been taken into account.


CONCLUSION
Endurance, muscular endurance, strength, balance and fine motor skills were impaired in patients with CKD 3b-5. Walking capacity, isometric quadriceps strength, balance, and fine motor skills were associated with declining GFR. The left extremities were more susceptible to GFR, ageing and comorbidities and seem thus to be more sensitive.
['Hellberg|Matthias|M|http://orcid.org/0000-0001-6248-1020', 'Höglund|Peter|P|http://orcid.org/0000-0002-8395-922X', 'Svensson|Philippa|P|', 'Abdulahi|Huda|H|', 'Clyne|Naomi|N|http://orcid.org/0000-0001-5284-4406']
D000328:Adult D000368:Aged D000369:Aged, 80 and over D003287:Contrast Media D003430:Cross-Sectional Studies D018450:Disease Progression D005081:Exercise Therapy D017079:Exercise Tolerance D005260:Female D005919:Glomerular Filtration Rate D018737:Hand Strength D006304:Health Status D006801:Humans D007472:Iohexol D007668:Kidney D008297:Male D008875:Middle Aged D009048:Motor Skills D018763:Muscle Fatigue D053580:Muscle Strength D004856:Postural Balance D011237:Predictive Value of Tests D052097:Quadriceps Muscle D051436:Renal Insufficiency, Chronic D000070857:Walk Test D055815:Young Adult
glomerular filtration rate endurance strength balance fine motor skills physical performance