Abstract
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.
Highlights
A previous cohort study indicated a significant association of lower baseline level of physical activity in hemodialysis patients with elevated risks of mortality
Inactive could contribute to mortality excess of hemodialysis patient, as hemodialysis patients are inactive compared to individuals with normal kidney function [1,2,3,4] and approximately 60% of hemodialysis patients were reported to exercise less than once a week [5]
Age and physical activity at baseline and 12 months were different between groups, but no significant differences were observed in other baseline characteristics between groups
Summary
A previous cohort study indicated a significant association of lower baseline level of physical activity in hemodialysis patients with elevated risks of mortality. 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. A previous systematic review indicated a significant association between lower baseline level of physical activity and elevated risks of chronic diseases, such as cancer, diabetes, and vascular disease [6]. Hemodialysis patients showed an association between lower initial levels of physical activity and elevated mortality risk [9,10,11,12,13].
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