Physical Activity and Quality of Life in Hemodialysis Patients and Healthy Controls: A Cross-Sectional Study.

Tjaša Filipčič,Maja Pajek,Jernej Pajek,Špela Bogataj

doi:10.3390/ijerph18041978

Abstract

Hemodialysis (HD) patients have lower functional abilities compared to healthy people, and this is associated with lower physical activity in everyday life. This may affect their quality of life, but research on this topic is limited. Therefore, the present study aimed to determine the relationship between habitual physical activity and quality of life in HD patients and healthy controls. Ninety-three HD patients and 140 controls participated in the study. Quality of life was assessed using a 36-item medical outcomes study short-form health survey (SF-36). Human Activity Profile (HAP) was used to assess habitual physical activity. The adjusted activity score (AAS) from HAP, age, gender, fat tissue index (FTI), lean tissue index (LTI), and Davies comorbidity score were analyzed as possible predictors of the Physical Component Summary (PCS) of the SF-36. Three sequential linear models were used to model PCS. In Model 1, PCS was regressed by gender and age; in Model 2 the LTI, FTI, and Davies comorbidity scores were added. Model 3 also included AAS. After controlling for age and gender (ModelHD 1: p = 0.056), LTI, FTI, and Davies comorbidity score effects (ModelHD 2: p = 0.181), the AAS accounted for 32% of the variation in PCS of HD patients (ModelHD 3: p < 0.001). Consequently, the PCS of HD patients would increase by 0.431 points if the AAS increased by one point. However, in healthy controls, AAS had a lower impact than in the HD sample (B = 0.359 vs. 0.431), while the corresponding effects of age and gender (ModelH 1: p < 0.001), LTI, FTI, and Davies comorbidity score (ModelH 2: p < 0.001) were adjusted for. The proportion of variation in PCS attributed to AAS was 14.9% (ModelH 3: p < 0.001). The current study results showed that physical activity in everyday life as measured by the HAP questionnaire is associated to a higher degree with the quality of life of HD patients than in healthy subjects. Routine physical activity programs are therefore highly justified, and the nephrology community should play a leading role in this effort.

Highlights

Patients with end-stage renal disease (ESRD) treated with hemodialysis (HD) report lower physical functioning and lower quality of life compared to the healthy population [1,2,3].Impaired physical functioning affects overall health and is associated with a reduced survival rate in this population [4,5,6].The scientific literature shows that physical inactivity is a common phenomenon in HD patients, exercise has been shown to be safe and to have numerous positive effects in those patients [7,8,9,10]
The adjusted activity score (AAS) from Human Activity Profile (HAP), age, gender, fat tissue index (FTI), lean tissue index (LTI), and Davies comorbidity score were analyzed as possible predictors of the Physical Component Summary (PCS) of the the 36-item short-form health survey questionnaire (SF-36)
Predictors gender age Abbreviations: ModelHD, model with hemodialysis patients; HAP AAS, human activity profile adjusted activity score; LTI, lean tissue index; FTI, fat tissue index; B, unstandardized coefficient with 95% confidence intervals; β, standardized coefficient; R2, coefficient of determination; F, F statistic; AIC, Akaike information criterion; n, number of subjects; * significant at p < 0.05; *** significant at p < 0.001; ModelHD 1: α = 56.817; ModelHD 2: α = 53.490; ModelHD 3: α = 23.103

Summary

Introduction

Patients with end-stage renal disease (ESRD) treated with hemodialysis (HD) report lower physical functioning and lower quality of life compared to the healthy population [1,2,3].Impaired physical functioning affects overall health and is associated with a reduced survival rate in this population [4,5,6].The scientific literature shows that physical inactivity is a common phenomenon in HD patients, exercise has been shown to be safe and to have numerous positive effects in those patients [7,8,9,10]. Patients with end-stage renal disease (ESRD) treated with hemodialysis (HD) report lower physical functioning and lower quality of life compared to the healthy population [1,2,3]. Impaired physical functioning affects overall health and is associated with a reduced survival rate in this population [4,5,6]. The scientific literature shows that physical inactivity is a common phenomenon in HD patients, exercise has been shown to be safe and to have numerous positive effects in those patients [7,8,9,10]. Given that HD patients report comorbidities associated with physical inactivity, determining the physical activity level is crucial for planning interventions to increase their mobility [1].

Methods

Discussion

Conclusion