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

• Published in: Physiological reports Vol. 12; no. 16; pp. e70014 - n/a
• Main Authors: Zhang, Kun, Li, Xin, Guo, Qi, Ding, Wei, Niu, Jianying, Zhao, Junli, Zhang, Liming, Qi, Hualin, Zhang, Suhua, Yu, Chen
• Format: Journal Article
• Language: English
• Published: United States John Wiley & Sons, Inc 01.08.2024; John Wiley and Sons Inc; Wiley
• Subjects: Adult; Aged; Body mass index; Cardiovascular disease; Cardiovascular diseases; Cardiovascular Diseases - epidemiology; Cardiovascular Diseases - etiology; Cardiovascular Diseases - physiopathology; China - epidemiology; Cholesterol; Comorbidity; Cross-Sectional Studies; Diabetes; Female; Fistula; Hand Strength; Heart Disease Risk Factors; Hemodialysis; Humans; Hypertension; Kidney diseases; Kidney Failure, Chronic - epidemiology; Kidney Failure, Chronic - physiopathology; Kidney Failure, Chronic - therapy; Kidney transplantation; Laboratories; Lower Extremity; lower extremity function; Male; Malnutrition; Middle Aged; Mortality; Muscle function; Muscle strength; Original; Peritoneal dialysis; Regular Manuscript; Renal Dialysis - adverse effects; Risk Factors; Variables; Walking; China; United States > US; lower extremity function; hemodialysis; cardiovascular disease
• ISSN: 2051-817X; 2051-817X
• DOI: 10.14814/phy2.70014

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.