title: Mild chronic kidney disease and functional impairment in community-dwelling older adults.
abstract: BACKGROUND
  chronic kidney disease (CKD) has been associated with an increased risk of death and cardiovascular events, but its relationship with non-vascular outcomes, including functional impairment (FI), is less well understood.
  
  
  OBJECTIVE
  in this study, we review the association between CKD and FI, adjusting for potential confounders and risk factors, with a primary outcome of impairment in any instrumental ADL (IADL) or basic ADL (BADL).
  
  
  METHODS
  the Cardiovascular Multimorbidity in Primary Care Study (CLARITY) is a cross-sectional study of community-dwelling adults.
  
  
  METHODS
  participants were adults living in the West of Ireland attending university-affiliated general practices.
  
  
  METHODS
  all participants were adults aged ≥50 years living in the community.
  
  
  METHODS
  CKD was defined as an estimated glomerular filtration rate (eGFR) ≤60 ml/min/1.73 m(2). A standardised self-reported health questionnaire to measure activities of daily living (ADL) was completed by participants. Logistic regression analyses were used to determine the independent association between CKD and FI.
  
  
  RESULTS
  a total of 3,499 patients were included with a mean age of 66.2 ± 10.3 years. 18.0% (n = 630) had CKD (mean eGFR 50.2 ± 9.2 ml/min/1.73m(2)), 21.9% (n = 138) of which had a diagnosis of CKD documented in medical records. 40.4% (n = 1,413) reported FI and multivariable adjustment showed CKD to be independently associated with FI (OR: 1.43, 1.15-1.78), impairment in IADL (OR: 1.43, 1.15-1.78) and impairment in BADL (OR: 1.39, 1.11-1.75).
  
  
  CONCLUSIONS
  our study shows even mild CKD is associated with FI, independent of age, gender, co-morbidities, traditional vascular risk factors and cardiovascular events.
authors: HRB Clinical Research Facility Galway, NUI, Galway, Geata an Eolais, Newcastle Road, Galway, Ireland. andrewsmyth@physicians.ie
authors: Andrew
authors: A
authors: Smyth
authors: Liam G
authors: LG
authors: Glynn
authors: Andrew W
authors: AW
authors: Murphy
authors: Joan
authors: J
authors: Mulqueen
authors: Michelle
authors: M
authors: Canavan
authors: Donal N
authors: DN
authors: Reddan
authors: Martin
authors: M
authors: O'Donnell
mesh_terms: D000203:Activities of Daily Living; D000367:Age Factors; D000368:Aged; D000369:Aged, 80 and over; D000375:Aging; D016009:Chi-Square Distribution; D015897:Comorbidity; D003430:Cross-Sectional Studies; D005260:Female; D015577:Geriatric Assessment; D005919:Glomerular Filtration Rate; D006801:Humans; D057187:Independent Living; D007494:Ireland / Q000453:epidemiology; D007668:Kidney / Q000503:physiopathology; D016015:Logistic Models; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D016017:Odds Ratio; D011237:Predictive Value of Tests; D011320:Primary Health Care; D011788:Quality of Life; D051436:Renal Insufficiency, Chronic / Q000175:diagnosis* / Q000453:epidemiology / Q000503:physiopathology / Q000523:psychology; D018570:Risk Assessment; D012307:Risk Factors; D012720:Severity of Illness Index; D011795:Surveys and Questionnaires
keywords: chronic kidney disease; functional impairment; quality of life