{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,29]],"date-time":"2026-09-29T16:57:19Z","timestamp":1790701039068,"version":"4.1.0"},"reference-count":0,"publisher":"Ovid Technologies (Wolters Kluwer Health)","content-domain":{"domain":["lww.com","ovid.com"],"crossmark-restriction":true},"short-container-title":["CJASN"],"abstract":"\n Background:<\/jats:title>\n Physical performance limitations are common in chronic kidney disease (CKD) and affect independence and survival, yet physical performance is not routinely assessed. We examined whether the Short Physical Performance Battery (SPPB), a multidimensional measure of lower-extremity physical performance, was longitudinally associated with incident heart failure, kidney failure, and mortality.<\/jats:p>\n <\/jats:sec>\n \n Methods:<\/jats:title>\n We evaluated Chronic Renal Insufficiency Cohort (CRIC) Study participants with \u22651 SPPB assessment, administered approximately every 2-3 years. SPPB was modeled per 1-point lower score, and categorically as low (0\u20136), moderate (7\u20139), and high (10\u201312) performance. Associations of baseline and time-updated SPPB with incident heart failure, incident kidney failure and mortality were evaluated using cause-specific Cox models adjusted for demographic and clinical characteristics.<\/jats:p>\n <\/jats:sec>\n \n Results:<\/jats:title>\n \n Among 3,038 participants, mean age was 63.5 years, 40% were non-Hispanic Black, and mean estimated glomerular filtration rate (eGFR) was 52 mL\/min\/1.73m\n 2<\/jats:sup>\n . Median follow-up was 8.5 years, and median baseline SPPB was 10 (8-11). Each 1-point lower baseline SPPB score was associated with 14% higher mortality risk but was not heart failure or kidney failure after full adjustment. In time-updated analyses, each 1-point lower SPPB was associated with a 10% higher heart failure risk and a 15% higher mortality risk. Low and moderate (vs high) SPPB performance categories were associated with 51% and 128% higher heart failure risk and 69% and 224% higher mortality risk, respectively. In contrast, neither baseline nor time-updated SPPB was independently associated with kidney failure.\n <\/jats:p>\n <\/jats:sec>\n \n Conclusions:<\/jats:title>\n Lower longitudinal physical performance was independently associated with higher risks of heart failure and mortality, but not kidney failure, among adults with CKD. The SPPB may help risk-stratify patients with CKD identifying those at high-risk for cardiovascular outcomes and mortality.<\/jats:p>\n <\/jats:sec>","DOI":"10.2215\/cjn.0000001219","type":"journal-article","created":{"date-parts":[[2026,9,29]],"date-time":"2026-09-29T16:01:40Z","timestamp":1790697700000},"update-policy":"https:\/\/doi.org\/10.1097\/lww.0000000000001000","source":"Crossref","is-referenced-by-count":0,"title":["Physical Performance and Risk of Heart Failure, Kidney Failure, and Mortality in CKD"],"prefix":"10.2215","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-7164-715X","authenticated-orcid":false,"given":"Devika","family":"Nair","sequence":"first","affiliation":[{"name":"Division of Nephrology and Hypertension, Department of Medicine, Vanderbilt University Medical Center, Nashville, TN, USA; Geriatric Research Education and Clinical Center, Veterans Affairs Tennessee Valley Healthcare System, Nashville, Tennessee; Veteran Wellbeing through Innovation Systems Science and Experience in Learning Health Systems (VETWISE-LHS) Center of Innovation, Nashville, Tennessee"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7483-4137","authenticated-orcid":false,"given":"Rebecca T.","family":"Brown","sequence":"additional","affiliation":[{"name":"Division of Geriatric Medicine, Department of Medicine; Perelman School of Medicine of the University of Pennsylvania"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-9559-204X","authenticated-orcid":false,"given":"Michael G.","family":"Shlipak","sequence":"additional","affiliation":[{"name":"Division of General Internal Medicine, Department of Medicine, University of California, San Francisco (UCSF), San Francisco, CA, USA; San Francisco VA Health Care System, San Francisco, CA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Navdeep","family":"Tangri","sequence":"additional","affiliation":[{"name":"Division of Nephrology, Department of Internal Medicine, Rady Faculty of Health Sciences (Max Rady College of Medicine), University of Manitoba, Winnipeg, MB, Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-8669-4530","authenticated-orcid":false,"given":"Xiaoming","family":"Zhang","sequence":"additional","affiliation":[{"name":"Department of Biostatistics, Epidemiology and Informatics; Center for Clinical Epidemiology and Biostatistics; Perelman School of Medicine of the University of Pennsylvania"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-8210-4564","authenticated-orcid":false,"given":"Mary F.","family":"Hannan","sequence":"additional","affiliation":[{"name":"Department of Biobehavioral Nursing Science, College of Nursing, University of Illinois Chicago, Chicago, IL"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mary B.","family":"Leonard","sequence":"additional","affiliation":[{"name":"Department of Pediatrics, Stanford University School of Medicine, Stanford, CA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-6580-4080","authenticated-orcid":false,"given":"James P","family":"Lash","sequence":"additional","affiliation":[{"name":"Division of Nephrology, Department of Medicine, College of Medicine, University of Illinois Chicago, Chicago, IL"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-4953-7795","authenticated-orcid":false,"given":"Sankar D.","family":"Navaneethan","sequence":"additional","affiliation":[{"name":"Section of Nephrology, Department of Medicine, Baylor College of Medicine, Houston, TX, USA; Michael E. DeBakey VA Medical Center, Houston, TX"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-9035-9126","authenticated-orcid":false,"given":"Jing","family":"Chen","sequence":"additional","affiliation":[{"name":"UT Southwestern; Division of Nephrology, Department of Internal Medicine, UT Southwestern Medical Center, Dallas, TX"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-8286-9652","authenticated-orcid":false,"given":"Jiang","family":"He","sequence":"additional","affiliation":[{"name":"UT Southwestern O\u2019Donnell School of Public Health, Department of Medicine and Neurology at UT Southwestern Medical Center, Dallas, TX"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-0673-6823","authenticated-orcid":false,"given":"Lawrence J","family":"Appel","sequence":"additional","affiliation":[{"name":"Johns Hopkins University School of Medicine and Johns Hopkins Bloomberg School of Public Health, Baltimore, MD"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-3559-4374","authenticated-orcid":false,"given":"Hernan","family":"Rincon-Choles","sequence":"additional","affiliation":[{"name":"Department of Kidney Medicine, Medical Specialty Institute, Cleveland Clinic Foundation, Cleveland, OH"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2552-8744","authenticated-orcid":false,"given":"Mayank","family":"Kansal","sequence":"additional","affiliation":[{"name":"Division of Cardiology, Department of Medicine, College of Medicine, University of Illinois Chicago, Chicago, IL"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-8984-4389","authenticated-orcid":false,"given":"Wei","family":"Yang","sequence":"additional","affiliation":[{"name":"Department of Biostatistics, Epidemiology and Informatics; Center for Clinical Epidemiology and Biostatistics; Perelman School of Medicine of the University of Pennsylvania"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2557-5161","authenticated-orcid":false,"given":"Sarah","family":"Schrauben","sequence":"additional","affiliation":[{"name":"Department of Medicine; Department of Biostatistics, Epidemiology and Informatics; Center for Clinical Epidemiology and Biostatistics; Perelman School of Medicine of the University of Pennsylvania"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"name":"the CRIC Study Investigators","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"276","published-online":{"date-parts":[[2026,9,29]]},"container-title":["Clinical Journal of the American Society of Nephrology"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.ovid.com\/10.2215\/CJN.0000001219","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,9,29]],"date-time":"2026-09-29T16:01:40Z","timestamp":1790697700000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.ovid.com\/10.2215\/CJN.0000001219"}},"subtitle":["Findings from the CRIC Study"],"short-title":[],"issued":{"date-parts":[[2026,9,29]]},"references-count":0,"URL":"https:\/\/doi.org\/10.2215\/cjn.0000001219","relation":{},"ISSN":["1555-9041","1555-905X"],"issn-type":[{"value":"1555-9041","type":"print"},{"value":"1555-905X","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,9,29]]},"assertion":[{"value":"2026-04-21","name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2026-09-23","name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}}]}}