Longitudinal Association Between Kidney Function Decline and Grip Strength Loss in Community-Dwelling Older Adults: A 6-Year Prospective Cohort Study.

AIM: Age-related functional decline in muscle strength is a major determinant of disability in older adults. Although kidney dysfunction has been implicated in sarcopenia, longitudinal evidence linking changes in kidney function with muscle strength decline in community-dwelling older adults remains limited. This study, part of the Kusatsu Cohort Study, aimed to examine whether 6-year changes in estimated glomerular filtration rate (eGFR) were associated with changes in handgrip strength and skeletal muscle mass index (SMI).

METHODS

A total of 279 residents in Kusatsu Town, Gunma Prefecture, aged ≥ 65 years participated in municipal checkups in 2019, 2021, 2023, and 2025. Handgrip strength, SMI, and eGFR (uncorrected for body surface area) were assessed. Six-year changes (Δgrip, ΔSMI, ΔeGFR) were calculated. Associations were examined using Pearson correlation and multivariable linear regression. ROC analysis evaluated the discriminatory ability of ΔeGFR for grip-strength decline.

RESULTS

Grip strength declined significantly over 6 years (28.5 ± 8.8-24.0 ± 7.6 kg, p < 0.001), whereas SMI remained stable (6.3 ± 1.0 to 6.2 ± 1.0 kg/m2, p = 0.10). Δgrip correlated positively with ΔeGFR (r = 0.30, p < 0.001). In multivariable analysis, ΔeGFR independently predicted Δgrip (β = 0.14, p = 0.03), along with sex and baseline grip strength. ROC analysis showed moderate discrimination (AUC 0.664), with an optimal ΔeGFR cutoff of -0.263 over 6 years (-4.4%/year).

CONCLUSIONS

Preservation of kidney function was independently associated with a smaller decline in handgrip strength among community-dwelling older adults. These findings highlight kidney-muscle crosstalk as a key mechanism of functional aging and support the use of eGFR decline as a biomarker for early detection of strength deterioration.