Physical performance links to heart failure and death in CKD
Among 3,038 adults with chronic kidney disease, each 1-point lower physical performance score was associated with a 10% higher heart failure risk and 15% higher mortality.
Clinical Journal of the American Society of Nephrology
In 3,038 adults with chronic kidney disease enrolled in the Chronic Renal Insufficiency Cohort Study, researchers tracked physical function over a median of 8.5 years. Participants had a mean age of 63.5 years and completed the Short Physical Performance Battery roughly every two to three years. Baseline physical performance predicted mortality—each 1-point lower score was associated with a 14% higher risk of death—but showed no independent link to heart failure or kidney failure after adjustment. In time-updated analyses, each 1-point decrease was linked to a 10% higher heart failure risk and a 15% higher mortality risk. SPPB scores did not associate with kidney failure.
Why it matters
Declining lower-extremity physical performance is a primary clinical marker of frailty and functional aging. These findings show that monitoring functional mobility over time can identify escalating systemic cardiovascular and mortality risks in patients with chronic disease, independent of renal progression.
Caveats
The observational design means these findings show associations rather than direct causation. In addition, physical performance was measured only every two to three years, which might miss shorter-term functional changes.
The paper
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Navdeep Tangri, Xiaoming Zhang, Mary F. Hannan, Mary Beth Leonard, James Phillip Lash, Sankar Dass Navaneethan, Jing Chen, Jiang He, Lawrence J. Appel, Hernan Rincon-Choles, Mayank Mohan Kansal, Wei Peter Yang, Sarah J. Schrauben,VA Tennessee Valley Healthcare System
Clinical Journal of the American Society of Nephrology · 29 Sep 2026