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Association of physical function and performance with peak VO2 in elderly patients with end stage kidney disease

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Abstract

Background

Physical function is impaired in end stage renal disease (ESRD). Various instruments have been used to assess the functional capabilities and health status of patients with ESRD, but it is not known which has the best association with peak VO2.

Aims

To assess the association between functional measures in ESRD.

Methods

Thirty nine elderly ESRD patients were evaluated with commonly used functional, health status, and quality of life measures, including maximal cardiopulmonary exercise testing (CPET), 6-min walk (6MWT), sit-to-stand test (STS), Veterans Specific Activity Questionnaire (VSAQ), upper and lower body strength, pulmonary function tests, and body composition determined by dual X-ray absorptiometry. The association between performance on these functional tools, clinical variables, and exercise test responses was assessed, and a non-exercise test multivariate model was developed to predict peak VO2.

Results

Peak VO2 was modestly related to VSAQ score (r = 0.59, p < 0.01), indices of upper and lower body strength (r = 0.45, p < 0.01 for both), and FEV1 (r = 0.51, p < 0.01). Functional and quality of life questionnaires were generally poorly related to one another and to peak VO2. In a multivariate model, 6MWT performance, forced expiratory volume in 1 s (FEV1), and VSAQ score were the best predictors of peak VO2, yielding a multiple R = 0.82, accounting for 67% of the variance in peak VO2.

Conclusion

Exercise capacity can be reasonably estimated using non-exercise test variables in patients with ESRD, including a symptom questionnaire (VSAQ), 6MWT and FEV1.

Clinical trial information

ClinicalTrials.gov identifier: NCT01990495. Registered Nov 21, 2013.

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Availability of data and material

The datasets generated during and/or analyzed during the current study are available from the corresponding author on reasonable request.

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Funding

This study was funded by the Department of Veterans Affairs, Rehabilitation Research and Development Grant # RX000915-01A1.

Author information

Authors and Affiliations

  1. Cardiology Division, Veterans Affairs Palo Alto Health Care System, Cardiology 111C, 3801 Miranda Ave, Palo Alto, CA, 94304, USA

    Jonathan Myers, Khin N. Chan & Yu Chen

  2. Cardiology Division, Stanford University, Stanford, CA, USA

    Jonathan Myers

  3. Nephrology Division, Veterans Affairs Palo Alto Health Care System, Palo Alto, CA, USA

    Khin N. Chan, Yiming Lit & Ralph Rabkin

  4. Nephrology Division, Stanford University, Stanford, CA, USA

    Yiming Lit & Ralph Rabkin

  5. Radiology Division, Veterans Affairs Palo Alto Health Care System, Palo Alto, CA, USA

    Payam Massaband

  6. Spinal Cord Injury Center, Veterans Affairs Palo Alto Health Care System, Palo Alto, CA, USA

    B. Jenny Kiratli

  7. Division of Nephrology, Department of Medicine, Stanford University Medical Center, Palo Alto, CA, USA

    Jane C. Tan

Authors
  1. Jonathan Myers
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  2. Khin N. Chan
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  8. Ralph Rabkin
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Contributions

JM and RR acquired funding for the study, performed data analysis and drafted the manuscript. KH, YC, YL, PM, RR, and JK acquired data, provided technical support, and provided input on the draft of the manuscript. All authors read and approved the final manuscript.

Corresponding author

Correspondence to Jonathan Myers.

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Conflicts of interest/Competing interest

The authors declare that they have no conflict of interest.

Statement of human and animal rights

The study was approved by the Stanford Panel on Human Subjects Research (#27400), and adheres to the CONSORT guidelines and the principles outlined in the Declaration of Helsinki.

Informed consent

All subjects signed a consent form approved by the Stanford University Panel on Human Subjects (protocol #27400).

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As part of consent to participate, all subjects agreed to have their data published.

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Myers, J., Chan, K.N., Chen, Y. et al. Association of physical function and performance with peak VO2 in elderly patients with end stage kidney disease. Aging Clin Exp Res 33, 2797–2806 (2021). https://doi.org/10.1007/s40520-021-01801-6

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  • DOI: https://doi.org/10.1007/s40520-021-01801-6

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