Quantitative gait markers and the TUG time in chronic kidney disease
Xin Zhang,
Hao Wang,
Heyang Lu,
Min Fan,
Weizhong Tian,
Yingzhe Wang,
Mei Cui,
Yanfeng Jiang,
Chen Suo,
Tiejun Zhang,
Li Jin,
Kelin Xu,
Xingdong Chen
Affiliations
Xin Zhang
School of Public Health, The Key Laboratory of Public Health Safety of Ministry of Education, Fudan University, Shanghai, China; Fudan University Taizhou Institute of Health Sciences, Taizhou, Jiangsu, China
Hao Wang
School of Public Health, The Key Laboratory of Public Health Safety of Ministry of Education, Fudan University, Shanghai, China; Fudan University Taizhou Institute of Health Sciences, Taizhou, Jiangsu, China
Heyang Lu
Department of Neurology, Huashan Hospital, Fudan University, Shanghai, China
Min Fan
Taixing Disease Control and Prevention Center, Taizhou, Jiangsu, China
Weizhong Tian
Taizhou People's Hospital Affiliated to Nantong University, Taizhou, Jiangsu, China
Yingzhe Wang
Fudan University Taizhou Institute of Health Sciences, Taizhou, Jiangsu, China; State Key Laboratory of Genetic Engineering, Zhangjiang Fudan International Innovation Center, School of Life Sciences, Human Phenome Institute, Fudan University, Shanghai, China
Mei Cui
Fudan University Taizhou Institute of Health Sciences, Taizhou, Jiangsu, China; Department of Neurology, Huashan Hospital, Fudan University, Shanghai, China
Yanfeng Jiang
Fudan University Taizhou Institute of Health Sciences, Taizhou, Jiangsu, China; State Key Laboratory of Genetic Engineering, Zhangjiang Fudan International Innovation Center, School of Life Sciences, Human Phenome Institute, Fudan University, Shanghai, China
Chen Suo
School of Public Health, The Key Laboratory of Public Health Safety of Ministry of Education, Fudan University, Shanghai, China; Fudan University Taizhou Institute of Health Sciences, Taizhou, Jiangsu, China
Tiejun Zhang
School of Public Health, The Key Laboratory of Public Health Safety of Ministry of Education, Fudan University, Shanghai, China; Fudan University Taizhou Institute of Health Sciences, Taizhou, Jiangsu, China
Li Jin
Fudan University Taizhou Institute of Health Sciences, Taizhou, Jiangsu, China; State Key Laboratory of Genetic Engineering, Zhangjiang Fudan International Innovation Center, School of Life Sciences, Human Phenome Institute, Fudan University, Shanghai, China
Kelin Xu
School of Public Health, The Key Laboratory of Public Health Safety of Ministry of Education, Fudan University, Shanghai, China; Fudan University Taizhou Institute of Health Sciences, Taizhou, Jiangsu, China; Corresponding author. School of Public Health, The Key Laboratory of Public Health Safety of Ministry of Education, Fudan University, Shanghai, China.
Xingdong Chen
Fudan University Taizhou Institute of Health Sciences, Taizhou, Jiangsu, China; State Key Laboratory of Genetic Engineering, Zhangjiang Fudan International Innovation Center, School of Life Sciences, Human Phenome Institute, Fudan University, Shanghai, China; National Clinical Research Center for Aging and Medicine, Huashan Hospital, Fudan University, Shanghai, China; Yiwu Research Institute of Fudan University, Yiwu, Zhejiang, China; Corresponding author. State Key Laboratory of Genetic Engineering, Zhangjiang Fudan International Innovation Center, School of Life Sciences, Human Phenome Institute, Fudan University, Shanghai, China.
Background: Poor gait performance results in more fall incidents among people with chronic kidney disease (CKD). It is unknown what specific quantitative gait markers contribute to high fall risk in CKD and the size of their mediation effects. Methods: We included 634 participants from the Taizhou Imaging Study who had complete gait and laboratory data. Quantitative gait assessment was conducted with a wearable insole-like device. Factor analysis was utilized to summarize fifteen highly correlated individual parameters into five independent gait domains. Prevalent CKD was defined as an estimated glomerular filtration rate (eGFR) < 60 ml/min per 1.73 m2, which was calculated based on cystatin C. Regression models were created to examine the associations of prevalent CKD with quantitative gait markers and the TUG time. Mediation analysis was used to investigate whether poor quantitative gait parameters could be mediators and the proportion of their mediation effects. Results: Participants with prevalent CKD had a higher TUG time (odds ratio = 2.02, P = 0.025) and poor gait performance in the phase domain (standardized β = −0.391, FDR = 0.009), including less time in the swing phase (standardized β = −0.365, FDR = 0.027) and greater time in the double-support phase (standardized β = 0.367, FDR = 0.027). These abnormalities mediated the association of prevalent CKD with a high TUG time (for the swing phase: 31.6 %, Pmediation = 0.044; for the double-support phase: 29.6 %, Pmediation = 0.042; for the phase domain: 26.9 %, Pmediation = 0.048). Conclusion: Poor phase-related gait abnormalities mediated the relationship between CKD and a high TUG time, suggesting that incorporating quantitative gait markers in specific domains may improve fall prevention programs for individuals with CKD.
