Changes in physical activity and risk of all-cause mortality in patients on maintence hemodialysis: a retrospective cohort study

BMC Nephrology

Research Article

Atsushi Yoshida¹  Yasuo Takeuchi²  Takahiro Shimoda³  Manae Harada³  Atsuhiko Matsunaga³  Takaaki Watanabe³  Mika Matsumoto³  Kei Yoneki³  Ryota Matsuzawa⁴ 

[1] Department of Hemodialysis Center, Sagami Circulatory Organ Clinic, Sagamihara, Japan;Department of Nephrology in Internal Medicine, Kitasato University School of Medicine, Sagamihara, Japan;Department of Rehabilitation Sciences, Kitasato University Graduate School of Medical Sciences, Sagamihara, Japan;Department of Rehabilitation, Kitasato University Hospital, 1-15-1 Kitasato, 252-0375, Sagamihara, Kanagawa, Japan;

关键词: Chronic renal failure;    Dialysis;    Exercise;    Survival analysis;   

DOI  :  10.1186/s12882-017-0569-7

 received in 2016-11-23, accepted in 2017-05-01,  发布年份 2017

来源: Springer

【 摘 要 】

BackgroundA previous cohort study indicated a significant association of lower baseline level of physical activity in hemodialysis patients with elevated risks of mortality. However, there have been no reports regarding the association between changes in physical activity over time and mortality in hemodialysis patients. This study was performed to examine the prognostic significance of physical activity changes in hemodialysis patients.MethodsThis retrospective cohort study was performed in 192 hemodialysis patients with a 7-year follow-up. The average number of steps taken per non-dialysis day was used as a measure of physical activity. Forty (20.8%) patients had died during the follow-up period. The percentage change in physical activity between baseline and 12 months was determined, and patients were divided into three categories according to changes in physical activity. A decrease or increase in physical activity > 30% was defined as becoming less or more active, respectively, while decrease or increase in physical activity < 30% were classified as stable.ResultsForty seven (24.5%), 51 (26.6%), and 94 (49.0%) patients were classified as becoming less active, becoming more active, and stable, respectively. The hazard ratio on multivariate analysis in patients with decreased physical activity was 3.68 (95% confidence interval, 1.55–8.78; P < 0.01) compared to those with increased physical activity.ConclusionsReductions in physical activity were significantly associated with poor prognosis independent of not only patient characteristics but also baseline physical activity. Therefore, improved prognosis in hemodialysis patients requires means of preventing a decline in physical activity over time.

【 授权许可】

CC BY   
© The Author(s). 2017