title: Association of Albuminuria and Estimated Glomerular Filtration Rate with Functional Performance Measures in Older Adults with Chronic Kidney Disease.
abstract: BACKGROUND
  Chronic kidney disease (CKD) is increasingly common and disproportionately affects older adults. The contribution of kidney disease to the functional impairment noted in the elderly CKD population is unclear.
  
  
  METHODS
  This is a cross-sectional analysis of a hypertensive cohort of people aged ≥75 years from the Systolic Blood Pressure Intervention Trial. We evaluated estimated glomerular filtration rate (eGFR) and urine albumin-to-creatinine ratio (UACR) as predictors of 3 measures of functional status: EuroQol-5 Dimensional (EQ-5D) score, Falls Efficacy Scale (FES) score, and gait speed. Linear regression models were used to evaluate the associations between our independent variables and outcome measures.
  
  
  RESULTS
  Our analysis included 2,620 participants, mean age of 79.9 (4.0) years. Unadjusted models showed that lower eGFR level and higher UACR level were associated with lower EQ-5D (p < 0.001 for both) and slower gait speed (p < 0.001 for both) and worse scores on FES (p = 0.032 and p = 0.039). In the fully adjusted models, higher levels of UACR remained significantly associated with lower EQ-5D scores and slower gait speed (p = 0.011 and p = 0.002, respectively). In contrast, level of eGFR was not associated with any functional outcome measures when accounting for covariates.
  
  
  CONCLUSIONS
  In individuals aged ≥75 years, albuminuria and eGFR were associated with impairments in physical performance and self-reported functional status; however, only the association with albuminuria remained after adjusting for relevant demographics and comorbidities. Evaluation of albuminuria may provide an additional tool for identifying older individuals at risk for functional impairment.
authors.affiliation: Medicine Division, Section of Nephrology, Milwaukee VA Medical Center, Milwaukee, WI, USA.
authors.forename: Dawn F
authors.initials: DF
authors.lastname: Wolfgram
authors.forename: Katelyn
authors.initials: K
authors.lastname: Garcia
authors.forename: Greg
authors.initials: G
authors.lastname: Evans
authors.forename: Sara
authors.initials: S
authors.lastname: Zamanian
authors.forename: Rocky
authors.initials: R
authors.lastname: Tang
authors.forename: Thomas
authors.initials: T
authors.lastname: Wiegmann
authors.forename: Rajeev
authors.initials: R
authors.lastname: Sharma
authors.forename: Ruth
authors.initials: R
authors.lastname: Campbell
authors.forename: Jeff
authors.initials: J
authors.lastname: Whittle
mesh_terms: D000058:Accidental Falls; D000203:Activities of Daily Living; D000367:Age Factors; D000368:Aged; D000369:Aged, 80 and over; D000419:Albuminuria / Q000652:urine*; D015331:Cohort Studies; D015897:Comorbidity; D003404:Creatinine / Q000652:urine; D003430:Cross-Sectional Studies; D005260:Female; D005919:Glomerular Filtration Rate; D006801:Humans; D006973:Hypertension / Q000453:epidemiology / Q000652:urine*; D007677:Kidney Function Tests; D008297:Male; D010809:Physical Fitness; D015995:Prevalence; D051436:Renal Insufficiency, Chronic / Q000453:epidemiology / Q000652:urine*; D057566:Self Report; D000072797:Walking Speed
chemical_list: D003404:Creatinine