Gait speed in nondialysis chronic kidney disease patients: role of peripheral neuropathy and cognitive impairment

Background Peripheral neuropathy (PN) and cognitive impairment are common consequences of chronic kidney disease (CKD) and can lead to detrimental effects on gait. This study assessed the prevalence of PN and cognitive function decline and their impact on gait speed among CKD patients. Patients and methods A cross-sectional study was conducted on 100 nondisabled adult CKD patients, who attended the nephrology outpatient clinic between June 2022 and March 2023. The total neuropathy score was used to evaluate the existence and severity of PN. The validated Arabic version of the Montreal Cognitive Assessment was used to evaluate global cognition through in-person interviews. For gait assessment, usual and maximal gait speeds were quantified over a 10-m walkway. Cognitive–motor interference was assessed by a walking-while-talking test over the same walkway. Results The studied patients’ median age and estimated glomerular filtration rate were 54 years and 11.2 ml/min/1.73 m 2 , respectively. PN was highly prevalent (69%). Only age was a statistically significant independent predictor of neuropathy on multivariate analysis. For every additional year of age, the odds of exhibiting PN increase by 10.7% (95% confidence interval: 1.05–1.17). Cognitive impairment was detected in 32% of patients. Multiple linear regression adjusted for sex, diabetes, and BMI indicated that slower usual gait speed was independently associated with older age, higher total neuropathy score scores, and poorer cognitive function (P=0.028, P=0.019, and P<0.001, respectively). Conclusion CKD is associated with impaired gait speed, possibly linked to PN severity and poor cognition. Early interventions might improve patient outcomes.