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Disclosure of Interest
Matthias Hellberg

No interest conflicts to declare

The details of each Disclosure of Interest are available at the Invited Speakers desk
(located in the Registration Area).

ERA-EDTA 2015

Self-perceived physical function and


quality of life in relation to GFR and
measured physical function
M Hellberg1, MD, P Hglund2, MD, PhD, H Abdulahi1, BSc, P Svensson1, BSc, N Clyne1, MD, PhD
1Department

of Nephrology, 2 Department of Clinical Pharmacology, Lund University, Sweden

Background
Cross sectional base line data analysis CKD 3b-5
Measured GFR
Measured physical functions
Endurance (6-MWT)
Strength (Quadriceps)
Balance (Functional Reach)
Fine motor skills (Mobergs Picking Up Test)

KDQOL-SFTM (Kidney Disease Quality of Life Short


Form)

Patients and Methods


Baseline data
40 women and 61 men
n=101

Age (years)
GFR (1.73ml/min/1.73m

67 13
2)

P-Alb (g/L)
Hb (g/L)

GFR (Iohexol clearance)


Multivariable linear regression
analysis
(Age, Sex, Comorbidity by Davies`
index)

21.5 7.6
37 3
128 13

24-h-BP day (mmHg)

134/77 15/11

24-h-BP night (--)

120/65 23/13

Cardiovascular
morbidity

20%

Diabetes (I+II)

34%

Antihypertensive
medicine

96%

Association between decline in GFR


and impairment of physical functions

1. Endurance (6-MWT)
p=0.037
2. Strength (Q-ceps)
p=0.035

3. Balance (Functional Reach)


p=0.024
4. Fine motor skills (Picking Up Test) p=0.015

What was the relation between


KDQOL domains and GFR?

Association between decline in GFR


and KDQOL-SFTM domains
Effects of kidney disease

(p=0.023)

Burden of kidney disease

(p=0.016)

Social support

(p=0.006)

All other domains of KDQOL-SFTM

(p>0.05)

(symptom problem list, work status, cognitive function, quality of social interaction,
sexual function, sleep, dialysis staff encouragement, overall health, patients
satisfaction, physical functioning, role physical, pain, general health, emotional
well-being, role emotional, social function, energy fatigue, SF 12 physical and
mental composite)

What was the relation between


KDQOL domains and
measured physical functions?

Role Physical
Strength
2500

Endurance

women, no comorbidity
women, comorbidity
men, no comorbidity
men, comorbidity

1500
500

1000

Qceps strength (kg*cm)

400
300
200

20

40

60

Role Physical (score)

age = 60y
age = 70y
age = 80y

age = 60y
age = 70y
age = 80y

100

6MWT (m)

500

2000

600

women, no comorbidity
women, comorbidity
men, no comorbidity
men, comorbidity

80

100

20

40

60

Role Physical (score)

80

100

Role Physical
Strength
2500

Endurance

women, no comorbidity
women, comorbidity
men, no comorbidity
men, comorbidity

1500
500

1000

Qceps strength (kg*cm)

400
300
200

20

40

60

Role Physical (score)

age = 60y
age = 70y
age = 80y

age = 60y
age = 70y
age = 80y

100

6MWT (m)

500

2000

600

women, no comorbidity
women, comorbidity
men, no comorbidity
men, comorbidity

80

100

20

40

60

Role Physical (score)

80

100

Role Physical
Strength
2500

Endurance

women, no comorbidity
women, comorbidity
men, no comorbidity
men, comorbidity

1500
500

1000

Qceps strength (kg*cm)

400
300
200

20

40

60

Role Physical (score)

age = 60y
age = 70y
age = 80y

age = 60y
age = 70y
age = 80y

100

6MWT (m)

500

2000

600

women, no comorbidity
women, comorbidity
men, no comorbidity
men, comorbidity

80

100

20

40

60

Role Physical (score)

80

100

Role Physical
Strength
2500

Endurance

women, no comorbidity
women, comorbidity
men, no comorbidity
men, comorbidity

1500
500

1000

Qceps strength (kg*cm)

400
300
200

20

40

60

Role Physical (score)

age = 60y
age = 70y
age = 80y

age = 60y
age = 70y
age = 80y

100

6MWT (m)

500

2000

600

women, no comorbidity
women, comorbidity
men, no comorbidity
men, comorbidity

80

100

20

40

60

Role Physical (score)

80

100

Role Physical
Strength
2500

Endurance

women, no comorbidity
women, comorbidity
men, no comorbidity
men, comorbidity

1500
500

1000

Qceps strength (kg*cm)

400
300
200

20

40

60

Role Physical (score)

age = 60y
age = 70y
age = 80y

age = 60y
age = 70y
age = 80y

100

6MWT (m)

500

2000

600

women, no comorbidity
women, comorbidity
men, no comorbidity
men, comorbidity

80

100

20

40

60

Role Physical (score)

80

100

Emotional well-being
Strength
2500

Endurance

women, no comorbidity
women, comorbidity
men, no comorbidity
men, comorbidity

1500
500

1000

Qceps strength (kg*cm)

400
300
200

20

age = 60y
age = 70y
age = 80y

age = 60y
age = 70y
age = 80y

100

6MWT (m)

500

2000

600

women, no comorbidity
women, comorbidity
men, no comorbidity
men, comorbidity

40

60

Emotional wellbeing (score)

80

100

20

40

60

Emotional wellbeing (score)

80

100

Emotional well-being
Strength
2500

Endurance

women, no comorbidity
women, comorbidity
men, no comorbidity
men, comorbidity

1500
500

1000

Qceps strength (kg*cm)

400
300
200

20

age = 60y
age = 70y
age = 80y

age = 60y
age = 70y
age = 80y

100

6MWT (m)

500

2000

600

women, no comorbidity
women, comorbidity
men, no comorbidity
men, comorbidity

40

60

Emotional wellbeing (score)

80

100

20

40

60

Emotional wellbeing (score)

80

100

Emotional well-being
Strength
2500

Endurance

women, no comorbidity
women, comorbidity
men, no comorbidity
men, comorbidity

1500
500

1000

Qceps strength (kg*cm)

400
300
200

20

age = 60y
age = 70y
age = 80y

age = 60y
age = 70y
age = 80y

100

6MWT (m)

500

2000

600

women, no comorbidity
women, comorbidity
men, no comorbidity
men, comorbidity

40

60

Emotional wellbeing (score)

80

100

20

40

60

Emotional wellbeing (score)

80

100

Emotional well-being
Strength
2500

Endurance

women, no comorbidity
women, comorbidity
men, no comorbidity
men, comorbidity

1500
500

1000

Qceps strength (kg*cm)

400
300
200

20

age = 60y
age = 70y
age = 80y

age = 60y
age = 70y
age = 80y

100

6MWT (m)

500

2000

600

women, no comorbidity
women, comorbidity
men, no comorbidity
men, comorbidity

40

60

Emotional wellbeing (score)

80

100

20

40

60

Emotional wellbeing (score)

80

100

Emotional well-being
Strength
2500

Endurance

women, no comorbidity
women, comorbidity
men, no comorbidity
men, comorbidity

1500
500

1000

Qceps strength (kg*cm)

400
300
200

20

age = 60y
age = 70y
age = 80y

age = 60y
age = 70y
age = 80y

100

6MWT (m)

500

2000

600

women, no comorbidity
women, comorbidity
men, no comorbidity
men, comorbidity

40

60

Emotional wellbeing (score)

80

100

20

40

60

Emotional wellbeing (score)

80

100

Summary
1. Decline in GFR is associated with impaired measured
endurance, strength, balance and fine motor skills
2. Decline in GFR is associated with self-perceived effects
and burden of kidney disease and social support in the
KDQOL-SFTM

3. Decline in GFR is not associated with any of the other


domains in the KDQOL-SFTM
4. Sex, age and comorbidity are the dominating factors in
the domains of functioning and well-being in the
KDQOL-SFTM
5. Self-perceived Role Physical and Emotional Well-being
in KDQOL-SFTM are associated with measured
endurance and strength

Conclusion
The KDQOL-SFTM questionnaire does not detect CKD
related impairment of physical function
Measurement of physical function in patients with CKD is
necessary in order to diagnose level and type of
impairment and construct an exercise training
programme.
The tests should include measurement of
Endurance
Strength
Balance
Fine motor skills

RENEXC
WWW.CLINICALTRIALS.COM

NCT02041156

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