# Lage fysieke fitheid verhoogt hartfalen- en sterfterisico bij CKD — CRIC

*geplaatst 2026-10-06 · Nierziekte · Clinical journal of the American Society of Nephrology : CJASN · doi 10.2215/CJN.0000001219 · https://hartvaat.nl/2026/09/29/lage-fysieke-fitheid-verhoogt-hartfalen-en-sterfterisico-bij-ckd-cric/*

In de CRIC-cohortstudie onderzochten onderzoekers of de Short Physical Performance Battery (SPPB) voorspellend was voor hartfalen, nierfalen en sterfte bij 3.038 patiënten met chronische nierziekte. Tijd-geupdate analyses toonden aan dat elk punt lager SPPB-score gepaard ging met een 10% hoger hartfalenrisico en een 15% hoger sterfterisico; patiënten met een lage fitheid hadden respectievelijk 51% en 69% meer kans op deze uitkomsten. De SPPB kan daarom dienen als eenvoudig hulpmiddel om CKD-patiënten met een hoog cardiovasculair risico te identificeren.

## English: Physical Performance and Risk of Heart Failure, Kidney Failure, and Mortality in CKD: Findings from the CRIC Study.

In the CRIC cohort study, researchers evaluated whether the Short Physical Performance Battery (SPPB) predicts heart failure, kidney failure, and mortality in 3,038 patients with chronic kidney disease. Time-updated analyses revealed that each one-point lower SPPB score was associated with a 10% higher risk of heart failure and a 15% higher risk of mortality; those with low physical performance had 51% and 69% higher risks, respectively. The SPPB may serve as a practical tool for cardiovascular risk stratification in CKD, although no independent association with kidney failure was observed.

## Abstract (original, from the publication)

BACKGROUND: 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. METHODS: We evaluated Chronic Renal Insufficiency Cohort (CRIC) Study participants with ≥1 SPPB assessment, administered approximately every 2-3 years. SPPB was modeled per 1-point lower score, and categorically as low (0-6), moderate (7-9), and high (10-12) 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. RESULTS: 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/1.73m2. 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. CONCLUSIONS: 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.

Auteurs: Devika Nair, Rebecca T Brown, Michael G Shlipak, Navdeep Tangri, Xiaoming Zhang, Mary F Hannan, Mary B Leonard, James P Lash, Sankar D Navaneethan, Jing Chen, Jiang He, Lawrence J Appel, Hernan Rincon-Choles, Mayank Kansal, Wei Yang, Sarah Schrauben

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Bron: Clinical journal of the American Society of Nephrology : CJASN, https://doi.org/10.2215/CJN.0000001219. Bijgewerkt 2026-09-30T00:52:32Z. Citeer vrij, met bronvermelding en een link naar hartvaat.nl (de url van het record). Samenvattingen zijn redactioneel werk van HartVaat; de oorspronkelijke publicaties blijven van hun uitgevers (doi). Geen medisch advies.