Physical and Functional Measures among Patients with Chronic Kidney Disease in High Prevalent Areas for CKDu: A Pilot Study

Abstract

Background: Chronic kidney disease of uncertain aetiology (CKDu) is a major health issue in some provinces in Sri Lanka. The prevalence of CKDu is vary from 15.1 to 22.9% in some districts in Sri Lanka. Since last three decades, highest number of CKDu patients were reported from North Central, Uva and North Western Provinces of the country. Objectives: To identify the physical and functional measures of chronic kidney disease (CKD) patients in high prevalent areas for CKDu. Methods: Patients with CKD (n=123) from CKDu high prevalence areas (Thanthirimale and Wilachchiya in North Central Province) were selected. Basic demographic characteristics, clinical information, physical measures [Height, Weight and Body Mass Index (BMI)] and functional measures [3m Gait Speed (GS), Hand Grip Strength (HGS)-dynamometer test, lower limb strength-30s Rapid Chair Stand (RCS)] were obtained. Apparently healthy individuals (n=23) from the same area (age and sex compatible) were selected as controls. Patients were categorized into three groups as group 1=stage 1and 2 (n=16), group 2=stage 3 (n=66) and group 3=stage 4 and 5 (n=41) CKD and apparently healthy individuals as a baseline group (n=23). Independent sample t-test and One-way ANOVA test were used to compare the groups. Results: The mean (SD) values of age, BMI, GS, HGS, RCS between patients and controls were, age; 60.72 (9.03) patients vs 51.74 (11.29) controls, p=0.001, BMI; 22.71 (4.32) patients vs 24.72 (3.87) controls, p=0.039, GS;0.71 (0.18) patients vs 0.89 (0.26) controls, p=0.006, HGS; 21.61 (7.72) patients vs 23.88 (7.47) controls, p=0.019, RCS; 7.52 (3.67) patients vs 10.87 (3.50) controls, p<0.001.One way ANOVA test revealed a significant difference between following groups.GS;0.69 (0.17) stage 3 and 0.89 (0.26) controls, (p=0.001), GS;0.71 (0.19) stage 4/5 and 0.89 (0.26) controls, (p=0.004), HGS;26.71 (9.82) stage 1/2 and 20.75 (6.85) stage 3, (p=0.032), RCS;7.23 (3.48) stage 3 and 10.87 (3.50) controls, (p<0.001), RCS;7.37 (3.87) stage 4/5 and 10.87 (3.50) controls, (p=0.002). No significant differences were noticed between patients with stage 1 and 2 CKD and controls (p>0.05) in all 3 functional tests. Conclusions: Significant decline of functional measures were observed in patients with stage 3, 4 and 5 CKD. However, no difference was observed between controls and patients with stage1 and 2 CKD.