Gait Speed and All-Cause Mortality in Whole-Spectrum Chronic Kidney Disease: A Systematic Review and Meta-Analysis Included 6217 Participants

IF 9.1 1区医学 Q1 GERIATRICS & GERONTOLOGY Journal of Cachexia Sarcopenia and Muscle Pub Date : 2025-02-24 DOI:10.1002/jcsm.13739

Fan Zhang, Hui Wang, Yan Bai, Liuyan Huang, Yifei Zhong, Yi Li

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Abstract

Background

The quantitative relationship between gait speed and mortality risk in patients with chronic kidney disease remains unclear. This study aimed to conduct a meta-analysis to estimate the risk of mortality associated with gait speed in chronic kidney disease (CKD) patients.

Methods

Relevant studies published were identified through literature searches using Embase, PubMed and Web of Science. Prospective cohort studies of adult CKD patients that examined the relationship between gait speed and mortality were included. Random effects meta-analyses based on restricted maximum likelihood to were used to calculate relative risk (RR) and 95% confidence interval (95% CI). The results of meta-analyses were assessed using Grading of Recommendations, Assessment, Development and Evaluation framework.

Results

Seventeen prospective cohort studies involving 6217 CKD patients (mean age range: 51.6–81.85 years; 44.3%–84% male) were included. Pooled analysis of 12 studies (n = 4233) showed that lower gait speed was associated with a higher risk of all-cause mortality compared to higher gait speed (RR = 2.138; 95% CI: 1.794–2.548; p < 0.001; I² = 16.0%; high-certainty evidence) in CKD patients. Dose–response meta-analysis of 6 studies (n = 1650) revealed that each 0.1 m/s increase in gait speed was associated with a 25.7% lower risk of all-cause mortality (RR = 0.743; 95% CI: 0.580–0.955; p = 0.018; I² = 45.0%; high-certainty evidence).

Conclusions

Slower gait speed is a strong predictor of all-cause mortality in CKD patients, including those undergoing dialysis or kidney transplantation. Gait speed assessment should be incorporated into routine clinical evaluations to identify high-risk patients and guide interventions aimed at improving physical function and survival outcomes.

Trial Registration: PROSPERO registration number: CRD42022340135

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全谱慢性肾脏疾病的步态速度和全因死亡率：一项包括6217名参与者的系统回顾和荟萃分析

慢性肾脏疾病患者的步态速度与死亡风险之间的定量关系尚不清楚。本研究旨在进行一项荟萃分析，以估计慢性肾脏疾病（CKD）患者与步态速度相关的死亡风险。方法通过Embase、PubMed、Web of Science等数据库检索已发表的相关研究。成人CKD患者的前瞻性队列研究检查了步态速度和死亡率之间的关系。基于限制最大似然的随机效应荟萃分析用于计算相对风险（RR）和95%置信区间（95% CI）。采用推荐、评估、发展和评价分级框架对meta分析结果进行评估。结果17项前瞻性队列研究涉及6217例CKD患者(平均年龄51.6-81.85岁；44.3%-84%男性)。12项研究（n = 4233）的汇总分析显示，与较高的步态速度相比，较低的步态速度与较高的全因死亡率相关(RR = 2.138；95% ci: 1.794-2.548；p < 0.001；i2 = 16.0%；高确定性证据)。6项研究（n = 1650）的剂量-反应荟萃分析显示，步态速度每增加0.1 m/s，全因死亡风险降低25.7% (RR = 0.743；95% ci: 0.580-0.955；p = 0.018；i2 = 45.0%；高确定性的证据)。结论：较慢的步态速度是CKD患者全因死亡率的一个强有力的预测因子，包括那些接受透析或肾移植的患者。步态速度评估应纳入常规临床评估，以识别高危患者，并指导旨在改善身体功能和生存结果的干预措施。试验注册：PROSPERO注册号：CRD42022340135

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来源期刊

Journal of Cachexia Sarcopenia and Muscle MEDICINE, GENERAL & INTERNAL-

CiteScore

13.30

自引率

12.40%

发文量

234

审稿时长

16 weeks

期刊介绍： The Journal of Cachexia, Sarcopenia and Muscle is a peer-reviewed international journal dedicated to publishing materials related to cachexia and sarcopenia, as well as body composition and its physiological and pathophysiological changes across the lifespan and in response to various illnesses from all fields of life sciences. The journal aims to provide a reliable resource for professionals interested in related research or involved in the clinical care of affected patients, such as those suffering from AIDS, cancer, chronic heart failure, chronic lung disease, liver cirrhosis, chronic kidney failure, rheumatoid arthritis, or sepsis.