TY - JOUR
T1 - Creatinine Clearance, Walking Speed, and Muscle Atrophy
T2 - A Cohort Study
AU - Roshanravan, Baback
AU - Patel, Kushang V.
AU - Robinson-Cohen, Cassianne
AU - De Boer, Ian H.
AU - O'Hare, Ann M.
AU - Ferrucci, Luigi
AU - Himmelfarb, Jonathan
AU - Kestenbaum, Bryan
PY - 2015/5/1
Y1 - 2015/5/1
N2 - Background: Chronic kidney disease is associated with malnutrition and inflammation. These processes may lead to loss of skeletal muscle and reduced physical performance. Associations of kidney function with muscle composition and longitudinal measures of physical performance are unknown. Study Design: Prospective cohort study. Setting & Participants: We evaluated 826 community-dwelling older adults enrolled in the Invecchiare in Chianti (InCHIANTI) Study who were free of baseline stroke or activities of daily living disability. Predictor: Baseline creatinine clearance (Clcr) based on 24-hour urine collection. Outcomes: Cross-sectional and longitudinal trajectories of physical performance measured by 7-m usual gait speed, 400-m fast gait speed, and knee extension strength using isometric dynamometry. Calf muscle composition assessed by quantitative computed tomography. Results: Mean age of participants was 74 ± 7 (SD) years, with 183 having Clcr <60 mL/min/1.73 m2. After adjustment, each 10-mL/min/1.73 m2 decrement in Clcr was associated with 0.01 (95% CI, 0.004-0.017) m/s slower 7-m usual walking speed and 0.008 (95% CI, 0.002-0.014) m/s slower 400-m walking speed. Each 10-mL/min/1.73 m2 decrement in Clcr was associated with 28 (95% CI, 0.8-55) mm2 lower muscle area and 0.15 (95% CI, 0.04-0.26) mg/cm3 lower muscle density. After adjustment, lower Clcr was associated with slower mean 7-m (P = 0.005) and 400-m (P = 0.02) walk and knee extension strength (P = 0.001) during the course of follow-up. During a mean follow-up of 7.1 ± 2.5 years, each 10-mL/min/1.73 m2 lower baseline Clcr was associated with 0.024 (95% CI, 0.01-0.037) kg/y greater decline in knee strength. Limitations: Single baseline measurement of Clcr and 3-year interval between follow-up visits may lead to nondifferential misclassification and attenuation of estimates. Conclusions: Among older adults, lower Clcr is associated with muscle atrophy, reduced walking speed, and more rapid declines in lower-extremity strength over time.
AB - Background: Chronic kidney disease is associated with malnutrition and inflammation. These processes may lead to loss of skeletal muscle and reduced physical performance. Associations of kidney function with muscle composition and longitudinal measures of physical performance are unknown. Study Design: Prospective cohort study. Setting & Participants: We evaluated 826 community-dwelling older adults enrolled in the Invecchiare in Chianti (InCHIANTI) Study who were free of baseline stroke or activities of daily living disability. Predictor: Baseline creatinine clearance (Clcr) based on 24-hour urine collection. Outcomes: Cross-sectional and longitudinal trajectories of physical performance measured by 7-m usual gait speed, 400-m fast gait speed, and knee extension strength using isometric dynamometry. Calf muscle composition assessed by quantitative computed tomography. Results: Mean age of participants was 74 ± 7 (SD) years, with 183 having Clcr <60 mL/min/1.73 m2. After adjustment, each 10-mL/min/1.73 m2 decrement in Clcr was associated with 0.01 (95% CI, 0.004-0.017) m/s slower 7-m usual walking speed and 0.008 (95% CI, 0.002-0.014) m/s slower 400-m walking speed. Each 10-mL/min/1.73 m2 decrement in Clcr was associated with 28 (95% CI, 0.8-55) mm2 lower muscle area and 0.15 (95% CI, 0.04-0.26) mg/cm3 lower muscle density. After adjustment, lower Clcr was associated with slower mean 7-m (P = 0.005) and 400-m (P = 0.02) walk and knee extension strength (P = 0.001) during the course of follow-up. During a mean follow-up of 7.1 ± 2.5 years, each 10-mL/min/1.73 m2 lower baseline Clcr was associated with 0.024 (95% CI, 0.01-0.037) kg/y greater decline in knee strength. Limitations: Single baseline measurement of Clcr and 3-year interval between follow-up visits may lead to nondifferential misclassification and attenuation of estimates. Conclusions: Among older adults, lower Clcr is associated with muscle atrophy, reduced walking speed, and more rapid declines in lower-extremity strength over time.
KW - chronic kidney disease (CKD)
KW - creatinine clearance (Clcr)
KW - longitudinal trajectory
KW - mobility impairment
KW - muscle atrophy
KW - muscle strength
KW - Physical performance
KW - renal function
KW - skeletal muscle composition
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U2 - 10.1053/j.ajkd.2014.10.016
DO - 10.1053/j.ajkd.2014.10.016
M3 - Article
C2 - 25542415
AN - SCOPUS:84929030127
VL - 65
SP - 737
EP - 747
JO - American Journal of Kidney Diseases
JF - American Journal of Kidney Diseases
SN - 0272-6386
IS - 5
ER -