Physical Activity Is An Important Prescription For Kidney Transplant Patients And Those Receiving Dialysis

Abstract

Chronic kidney disease (CKD) affects 13% of U.S. adults. Patients endure a disproportionate amount of cardiovascular complications with nearly 50% of dialysis patients experiencing a premature death related to cardiovascular disease. Although participation in regular physical activity can mitigate CKD complications, more than half of nephrologists fail to recommend it to their patients. PURPOSE: To investigate the effects of physical activity on hemoglobin and health outcomes in CKD patients. METHODS: We analyzed patients admitted to a hospital in the Midwestern United States. A comprehensive metabolic panel and health history, including physical activity (PA) levels, were obtained upon admittance. Patients were assigned a status of either active (N=23) or sedentary (N=45). Independent-samples t-tests and chi-squared tests compared sedentary and active groups. Linear and negative binomial regression models tested the effect of PA on Hb and hospital length of stay (LOS). RESULTS: Across the total sample, patients were 64.7 ± 17.4 years old, 40.3% were obese, they remained in the hospital for 6.9 ± 7.5 days, 16.2% received dialysis during treatment, 5.9% had a history of kidney transplant, and 4.4% died. Patients with a history of transplant had a reduction in Hb of 3.7 g/dL (p<0.001) and exhibited a trend for a higher rate of engagement in PA (p=0.073). Patients receiving dialysis had 2.4 g/dL lower Hb (p=0.006) and comparable rates of PA (p=0.616). All cases of mortality occurred in the sedentary group, and the Hb of patients who expired was 2.2 g/dL lower; owing to a small sample, this failed to reach significance (p=0.179). Physically active patients had 1.4 g/dL higher Hb (p=0.041). Holding constant transplant status and whether patients received dialysis, PA predicted an increase in Hb of 1.75 g/dL (p=0.007; 95% CI: 0.489 to 3.011) and a 96.4% shorter LOS (p=0.005; 95% CI of IRR: 0.003 to 0.373). In turn, Hb was a trending predictor of mortality; each additional g/dL predicted a 38.3% reduction in odds (p=0.069; 95% CI of OR: 0.367 to 1.038). CONCLUSION: Independent of dialysis and transplant status, engagement in regular physical activity elicited an increase in Hb and shortened hospital stays among CKD patients. Our findings reinforce the importance of physical activity prescription as a standard component of care.