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

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