Harold Simmons Center for Kidney Disease Research and Epidemiology, University of California Irvine School of Medicine, Orange.
Tibor Rubin Veterans Affairs Long Beach Healthcare System, Long Beach.
Curr Opin Nephrol Hypertens. 2022 Jan 1;31(1):109-128. doi: 10.1097/MNH.0000000000000763.
Low physical function, frailty, and sarcopenia are common complications of chronic kidney disease (CKD). In this article, we review the epidemiology and pathogenesis of low physical function, as well as its associations with adverse outcomes in CKD patients. Additionally, we present various traditional and novel methods for assessment of physical function in CKD patients.
In nondialysis dependent (NDD) and dialysis-dependent CKD patients, the prevalence of low physical function, frailty, and sarcopenia are substantially higher than in the general population. The potential mechanisms of low physical function, frailty, and sarcopenia in CKD patients are due to various factors including underlying kidney disease, co-existing comorbidities, and certain therapeutic interventions utilized in CKD. Increasing evidence has also uncovered the ill effects of impaired physical function on clinical outcomes in CKD patients.
Routine assessment of physical function is an under-utilized yet important component in the management of CKD patients. Future studies are needed to determine how prescription of exercise and increased daily physical activity can be tailored to optimize the health and well-being of NDD and dialysis-dependent CKD patients in pursuit of successful aging.
低身体机能、衰弱和肌肉减少症是慢性肾脏病(CKD)的常见并发症。本文综述了低身体机能的流行病学和发病机制,以及其与 CKD 患者不良结局的关系。此外,还介绍了用于评估 CKD 患者身体机能的各种传统和新型方法。
在非透析依赖(NDD)和透析依赖的 CKD 患者中,低身体机能、衰弱和肌肉减少症的患病率明显高于普通人群。CKD 患者低身体机能、衰弱和肌肉减少症的潜在机制归因于多种因素,包括基础肾脏疾病、并存的合并症以及 CKD 中使用的某些治疗干预措施。越来越多的证据也揭示了身体机能受损对 CKD 患者临床结局的不良影响。
常规评估身体机能是 CKD 患者管理中未得到充分利用但很重要的一个组成部分。需要进一步研究如何制定运动处方和增加日常体力活动,以优化非透析依赖和透析依赖的 CKD 患者的健康和幸福感,实现成功老龄化。