Fan Zhang, Hui Wang, Yan Bai, Liuyan Huang, Yifei Zhong, Yi Li
{"title":"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","authors":"Fan Zhang, Hui Wang, Yan Bai, Liuyan Huang, Yifei Zhong, Yi Li","doi":"10.1002/jcsm.13739","DOIUrl":null,"url":null,"abstract":"<div>\n \n \n <section>\n \n <h3> Background</h3>\n \n <p>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.</p>\n </section>\n \n <section>\n \n <h3> Methods</h3>\n \n <p>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.</p>\n </section>\n \n <section>\n \n <h3> Results</h3>\n \n <p>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 (<i>n</i> = 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; <i>p</i> < 0.001; <i>I</i><sup>2</sup> = 16.0%; high-certainty evidence) in CKD patients. Dose–response meta-analysis of 6 studies (<i>n</i> = 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; <i>p</i> = 0.018; <i>I</i><sup>2</sup> = 45.0%; high-certainty evidence).</p>\n </section>\n \n <section>\n \n <h3> Conclusions</h3>\n \n <p>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.</p>\n \n <p><b>Trial Registration:</b> PROSPERO registration number: CRD42022340135</p>\n </section>\n </div>","PeriodicalId":48911,"journal":{"name":"Journal of Cachexia Sarcopenia and Muscle","volume":"16 1","pages":""},"PeriodicalIF":9.4000,"publicationDate":"2025-02-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/jcsm.13739","citationCount":"0","resultStr":"{\"title\":\"Gait Speed and All-Cause Mortality in Whole-Spectrum Chronic Kidney Disease: A Systematic Review and Meta-Analysis Included 6217 Participants\",\"authors\":\"Fan Zhang, Hui Wang, Yan Bai, Liuyan Huang, Yifei Zhong, Yi Li\",\"doi\":\"10.1002/jcsm.13739\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<div>\\n \\n \\n <section>\\n \\n <h3> Background</h3>\\n \\n <p>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.</p>\\n </section>\\n \\n <section>\\n \\n <h3> Methods</h3>\\n \\n <p>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.</p>\\n </section>\\n \\n <section>\\n \\n <h3> Results</h3>\\n \\n <p>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 (<i>n</i> = 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; <i>p</i> < 0.001; <i>I</i><sup>2</sup> = 16.0%; high-certainty evidence) in CKD patients. Dose–response meta-analysis of 6 studies (<i>n</i> = 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; <i>p</i> = 0.018; <i>I</i><sup>2</sup> = 45.0%; high-certainty evidence).</p>\\n </section>\\n \\n <section>\\n \\n <h3> Conclusions</h3>\\n \\n <p>Slower gait speed is a strong predictor of all-cause mortality in CKD patients, including those undergoing dialysis or kidney transplantation. 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Gait Speed and All-Cause Mortality in Whole-Spectrum Chronic Kidney Disease: A Systematic Review and Meta-Analysis Included 6217 Participants
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.
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.
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