Sex Difference in the Association between Physical Activity and All-Cause Mortality in Ambulatory Patients with Chronic Kidney Disease.

Stig Molsted,Mette Aadahl,Inge Eidemak

doi:10.3390/ijerph18073698

Abstract

(1) Background: The purpose of this article was to investigate the association between self-reported physical activity (PA) and all-cause mortality in ambulatory patients with chronic kidney disease (CKD), stage 4–5 including maintenance dialysis. (2) Methods: Ambulatory patients with CKD (eGFR < 30 mL/min/1.73 m2) with conservative treatment or chronic dialysis were included. PA was assessed using the Saltin–Grimby Physical Activity Level Scale. A Cox proportional hazards regression model––adjusted for age, sex, plasma–albumin, body mass index, socioeconomic status, and treatment––was applied. (3) Results: Participants (n = 374) were followed 39 ± 15 months from entry to death or censoring. Throughout the study period of 39 months, 156 deaths (42%) were registered. Regarding physical activity, 128 (34%) of the participants were inactive, 212 (57%) were moderately active, and 34 (9%) were highly or vigorously active. Moderate PA was associated with a decreased mortality risk in women (n = 150) compared to inactivity (HR 0.27 (0.15; 0.51), p < 0.001), whereas a high/vigorous level of PA was not significantly associated with mortality risk compared to inactivity. In men (n = 224), the associations between PA levels and mortality risk were not significant. (4) Conclusions: Moderate PA was associated with reduced all-cause mortality in ambulatory women with stage 4–5 CKD with or without maintenance dialysis treatment. Physical activity was not significantly associated with mortality in men.

Highlights

Physical activity (PA) is associated with a reduced risk of all-cause mortality in the general population [1,2], and even a modest amount of regular PA below the recommended150 min of moderate-intensity PA per week [3] markedly reduces the risk of premature mortality [4]
An increased risk of all-cause mortality was found in physically inactive women with stage 4–5 chronic kidney disease (CKD) including maintenance dialysis treatment compared to women who were moderately physically active
This study found different associations between PA levels and mortality in women and men

Summary

Introduction

Physical activity (PA) is associated with a reduced risk of all-cause mortality in the general population [1,2], and even a modest amount of regular PA below the recommended150 min of moderate-intensity PA per week [3] markedly reduces the risk of premature mortality [4]. Physical activity (PA) is associated with a reduced risk of all-cause mortality in the general population [1,2], and even a modest amount of regular PA below the recommended. Previous studies have documented an association between PA and mortality in patients with chronic kidney disease (CKD) who undergo maintenance dialysis. In patients who had recently started hemodialysis (HD) or peritoneal dialysis (PD), an elevated mortality risk was observed in those who reported that they had never or almost never performed exercise training compared to those who exercised as little as “less than once a week” [5]. Likewise another study in patients who recently started HD or PD showed a dose-response relationship with decreased risk of all-cause mortality with increasing levels of self-reported PA [6].

Objectives

Methods

Results

Conclusion