Division of Geriatrics, Department of Internal Medicine, Asan Medical Center, University of Ulsan College of Medicine, Seoul, South Korea.
Total Healthcare Center, Kangbuk Samsung Hospital, B1, Samsung Main B/D, 67, Sejong-daero, Jung-gu, Seoul, 04514, South Korea.
BMC Nephrol. 2021 Mar 10;22(1):85. doi: 10.1186/s12882-021-02291-4.
Physical frailty has previously been associated with adverse clinical outcomes in patients with end-stage renal disease (ESRD). This study aimed to determine whether impaired physical performance at baseline is associated with the incidence of ESRD, using a nationwide database.
The timed up-and-go (TUG) test was used to assess physical frailty in 1,552,781 66-year-old individuals, using health examination database records from the Korean National Health Insurance Service. As a primary endpoint, incident ESRD was defined operationally using healthcare claims data from the Korean Health Insurance Review and Assessment Service.
Our results showed that baseline kidney function was significantly worse in individuals with TUG results of > 10 s compared to individuals with an intact TUG performance (≤10 s). Kaplan-Meier analysis showed a stepwise dose-response relationship between baseline physical performance and the incidence rate of ESRD (log-rank test P-value of < 0.001). An increasing ESRD incidence rate trend with poor physical performance remained significant after adjusting for characteristics such as baseline glomerular filtration rate and proteinuria.
Poor baseline physical performance was associated with an increased risk of ESRD, suggesting possible interactions between systemic frailty and vascular aging processes.
身体虚弱此前与终末期肾病（ESRD）患者的不良临床结局相关。本研究旨在使用全国范围内的数据库，确定基线时的身体机能下降是否与 ESRD 的发生有关。
使用健康体检数据库记录，从韩国国家健康保险服务中选取了 1,552,781 名 66 岁的个体，使用计时起立行走（TUG）测试来评估身体虚弱情况。将使用韩国健康保险审查与评估服务的医疗保健索赔数据定义为主要终点，操作定义为 ESRD 事件。
我们的结果表明，与 TUG 表现正常（≤10 秒）的个体相比，TUG 结果＞10 秒的个体的基线肾功能明显更差。Kaplan-Meier 分析显示，基线身体机能与 ESRD 发生率之间存在逐步剂量反应关系（对数秩检验 P 值＜0.001）。在调整了肾小球滤过率和蛋白尿等基线特征后，身体机能差与 ESRD 发生率增加的趋势仍然显著。
基线身体机能差与 ESRD 风险增加相关，这表明全身虚弱与血管老化过程之间可能存在相互作用。
