Lower extremity function and cardiovascular disease risk in hemodialysis patients: A multicenter cross-sectional study.

Publisher: published by Wiley Periodicals, Inc. on behalf of the American Physiological Society and The Physiological Society Country of Publication: United States NLM ID: 101607800 Publication Model: Print Cited Medium: Internet ISSN: 2051-817X (Electronic) Linking ISSN: 2051817X NLM ISO Abbreviation: Physiol Rep Subsets: MEDLINE

Original Publication: [Malden MA] : published by Wiley Periodicals, Inc. on behalf of the American Physiological Society and The Physiological Society, 2013-

Renal Dialysis*/adverse effects ; Lower Extremity* ; Cardiovascular Diseases*/epidemiology ; Cardiovascular Diseases*/etiology ; Cardiovascular Diseases*/physiopathology; Humans ; Male ; Female ; Middle Aged ; Cross-Sectional Studies ; Aged ; Hand Strength ; Adult ; Heart Disease Risk Factors ; Risk Factors ; China/epidemiology ; Kidney Failure, Chronic/therapy ; Kidney Failure, Chronic/physiopathology ; Kidney Failure, Chronic/epidemiology

Physical performance in hemodialysis patients declines and serves as a cardiovascular disease (CVD) incidence and mortality predictor. However, lower extremity function's role remains unclear. This study aimed to quantify the association between lower extremity function and CVD risk in hemodialysis patients. This was a multicenter cross-sectional study enrolling 868 participants (532 males, 336 females) from seven hemodialysis centers in Shanghai, China. Patients were divided into three groups per lower extremity function, evaluated by short physical performance battery (SPPB) scores: 0-6, 7-9, and 10-12. Upper extremity function was quantified through grip strength assessment. CVD risk was assessed using the Framingham Risk Score. Approximately 35% of hemodialysis patients had impaired lower extremity function (SPPB score < 10). Participants with high SPPB scores had stronger handgrip and lower Framingham CVD risk scores than those with low and moderate SPPB scores (p < 0.05). After adjusting clinical confounders, SPPB was independently associated with CVD risk, as a categorized variable (odds ratio: 0.577, 95% confidence interval [CI]: 0.388-0.857, p = 0.006) and as a continuous variable (odds ratio: 0.858, 95% CI: 0.772-0.953, p = 0.004). An SPPB score < 10 predicted an increased CVD risk (area under curve: 0.649, 95% CI: 0.599-0.699, p < 0.001). Causality between physical performance and CVD risk was not considered. Some upper limb results may not be generalizable to peritoneal dialysis and kidney transplant patients. Lower extremity function was significantly associated with CVD risk in hemodialysis patients. Further studies are needed to explore the long-term relationship between lower extremity function and CVD risk.
(© 2024 The Author(s). Physiological Reports published by Wiley Periodicals LLC on behalf of The Physiological Society and the American Physiological Society.)

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82172552 National Natural Science Foundation of China (NSFC); 22YF1417900 Shanghai Sailing Program; ITJ(QN)2106 Clinical Research Project of Tongji Hospital of Tongji University; ITJ(QN)2204 Clinical Research Project of Tongji Hospital of Tongji University

Keywords: cardiovascular disease; hemodialysis; lower extremity function

Date Created: 20240820 Date Completed: 20240820 Latest Revision: 20240823

20240823

PMC11335428

10.14814/phy2.70014

39164207