Frontiers in Public Health · Oct 30, 2026
Association of low physical performance assessed by five-time chair stand test with new-onset and severity of chronic kidney disease: hybrid evidence from public health and clinical settings
By Mengda Tang, Yu Cao, Jiachuan Xiong et al.
BackgroundThis study aimed to investigate the longitudinal association between low physical performance assessed by five-time chair stand test (CST, seconds) and new-onset chronic kidney disease (CKD) in middle-aged and older adults, and to explore their cross-sectional relationship in patients with established CKD.MethodsThis observational, multicenter cohort study included 4,593 community-dwelling adults without CKD at baseline in 2011. An additional 549 patients with CKD were included for an exploratory cross-sectional analysis. Baseline physical performance was measured using the five-time chair stand test. Participants without CKD were followed from 2011 to 2018, with incident CKD identified via self-reported clinician diagnoses. Restricted cubic spline (RCS) and discrete-time survival model with a complementary log–log link were employed to investigate the associations between CST and new-onset CKD. The cross-sectional association between CST and disease severity in CKD patients was analyzed using Spearman’s correlation and logistic regression.ResultsThere were 2,496 women and 2,097 men (median age = 58.0 years). During the seven-year follow-up, 485 CKD incidents occurred. RCS showed a linear-like association between CST and new-onset CKD in men (p = 0.018), but no statistically significant association was observed in women. Exploratory OS-derived CST thresholds were 10.38 s for men and 12.77 s for women and were used only for statistical categorization. Multivariable analysis further indicated that prolonged CST times were positively associated with CKD risk (HR = 1.490, 95%CI = 1.227 to 1.810). This relationship was strengthened in subjects with lower blood urea nitrogen levels. In the exploratory analysis, CST was significantly associated with CKD stage, end-stage kidney disease, and estimated glomerular filtration rate (eGFR) in men, but not in women.ConclusionIn this hypothesis-generating analysis, low physical performance, as indicated by prolonged CST time, was positively associated with new-onset CKD in middle-aged and older Chinese adults. A similar pattern was observed in male patients with CKD. Future studies are warranted to clarify whether early intervention could play a role in preventing the onset and progression of CKD.