Association of low physical performance assessed by five-time chair stand test with new-onset and severity of chronic kidney disease: hybrid evidence from public health and clinical settings
Abstract
BackgroundThis study aimed to investigate the longitudinal association between low physical performance assessed by five-time chair stand test (CST, seconds) and new-onset chronic kidney disease (CKD) in middle-aged and older adults, and to explore their cross-sectional relationship in patients with established CKD.MethodsThis observational, multicenter cohort study included 4,593 community-dwelling adults without CKD at baseline in 2011. An additional 549 patients with CKD were included for an exploratory cross-sectional analysis. Baseline physical performance was measured using the five-time chair stand test. Participants without CKD were followed from 2011 to 2018, with incident CKD identified via self-reported clinician diagnoses. Restricted cubic spline (RCS) and discrete-time survival model with a complementary log–log link were employed to investigate the associations between CST and new-onset CKD. The cross-sectional association between CST and disease severity in CKD patients was analyzed using Spearman’s correlation and logistic regression.ResultsThere were 2,496 women and 2,097 men (median age = 58.0 years). During the seven-year follow-up, 485 CKD incidents occurred. RCS showed a linear-like association between CST and new-onset CKD in men (p = 0.018), but no statistically significant association was observed in women. Exploratory OS-derived CST thresholds were 10.38 s for men and 12.77 s for women and were used only for statistical categorization. Multivariable analysis further indicated that prolonged CST times were positively associated with CKD risk (HR = 1.490, 95%CI = 1.227 to 1.810). This relationship was strengthened in subjects with lower blood urea nitrogen levels. In the exploratory analysis, CST was significantly associated with CKD stage, end-stage kidney disease, and estimated glomerular filtration rate (eGFR) in men, but not in women.ConclusionIn this hypothesis-generating analysis, low physical performance, as indicated by prolonged CST time, was positively associated with new-onset CKD in middle-aged and older Chinese adults. A similar pattern was observed in male patients with CKD. Future studies are warranted to clarify whether early intervention could play a role in preventing the onset and progression of CKD.
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BibTeX
@article{tang2026association,
title = {{Association of low physical performance assessed by five-time chair stand test with new-onset and severity of chronic kidney disease: hybrid evidence from public health and clinical settings}},
author = {Mengda Tang and Yu Cao and Jiachuan Xiong and Liang Liu and Tangli Xiao and Ling Nie and Liangyu Yin and Jinghong Zhao},
journal = {Frontiers in Public Health},
year = {2026},
month = nov,
doi = {10.3389/fpubh.2026.1955004},
url = {https://www.frontiersin.org/articles/10.3389/fpubh.2026.1955004},
note = {CC BY 4.0},
}
RIS
TY - JOUR
TI - Association of low physical performance assessed by five-time chair stand test with new-onset and severity of chronic kidney disease: hybrid evidence from public health and clinical settings
AU - Mengda Tang
AU - Yu Cao
AU - Jiachuan Xiong
AU - Liang Liu
AU - Tangli Xiao
AU - Ling Nie
AU - Liangyu Yin
AU - Jinghong Zhao
PY - 2026
DA - 2026/11/04
JO - Frontiers in Public Health
DO - 10.3389/fpubh.2026.1955004
UR - https://www.frontiersin.org/articles/10.3389/fpubh.2026.1955004
AB - BackgroundThis study aimed to investigate the longitudinal association between low physical performance assessed by five-time chair stand test (CST, seconds) and new-onset chronic kidney disease (CKD) in middle-aged and older adults, and to explore their cross-sectional relationship in patients with established CKD.MethodsThis observational, multicenter cohort study included 4,593 community-dwelling adults without CKD at baseline in 2011. An additional 549 patients with CKD were included for an exploratory cross-sectional analysis. Baseline physical performance was measured using the five-time chair stand test. Participants without CKD were followed from 2011 to 2018, with incident CKD identified via self-reported clinician diagnoses. Restricted cubic spline (RCS) and discrete-time survival model with a complementary log–log link were employed to investigate the associations between CST and new-onset CKD. The cross-sectional association between CST and disease severity in CKD patients was analyzed using Spearman’s correlation and logistic regression.ResultsThere were 2,496 women and 2,097 men (median age = 58.0 years). During the seven-year follow-up, 485 CKD incidents occurred. RCS showed a linear-like association between CST and new-onset CKD in men (p = 0.018), but no statistically significant association was observed in women. Exploratory OS-derived CST thresholds were 10.38 s for men and 12.77 s for women and were used only for statistical categorization. Multivariable analysis further indicated that prolonged CST times were positively associated with CKD risk (HR = 1.490, 95%CI = 1.227 to 1.810). This relationship was strengthened in subjects with lower blood urea nitrogen levels. In the exploratory analysis, CST was significantly associated with CKD stage, end-stage kidney disease, and estimated glomerular filtration rate (eGFR) in men, but not in women.ConclusionIn this hypothesis-generating analysis, low physical performance, as indicated by prolonged CST time, was positively associated with new-onset CKD in middle-aged and older Chinese adults. A similar pattern was observed in male patients with CKD. Future studies are warranted to clarify whether early intervention could play a role in preventing the onset and progression of CKD.
SN - 2296-2565
ER -