The association of physical activity and physical function with clinical outcomes in adults with chronic kidney disease

2013 ◽  
Vol 22 (6) ◽  
pp. 615-623 ◽  
Author(s):  
Patricia Painter ◽  
Baback Roshanravan
Keyword(s):  
Physical Activity ◽  
Chronic Kidney Disease ◽  
Kidney Disease ◽  
Physical Function ◽  
Clinical Outcomes

scholarly journals The association of physical function and physical activity with all-cause mortality and adverse clinical outcomes in nondialysis chronic kidney disease: a systematic review

2018 ◽  
Vol 9 (11) ◽  
pp. 209-226 ◽  
Author(s):  
Heather J. MacKinnon ◽  
Thomas J. Wilkinson ◽  
Amy L. Clarke ◽  
Douglas W. Gould ◽  
Thomas F. O’Sullivan ◽  
...  
Keyword(s):  
Physical Activity ◽  
Chronic Kidney Disease ◽  
Kidney Disease ◽  
Physical Function ◽  
Clinical Outcomes ◽  
Research Quality ◽  
Measurement Tool ◽  
Cochrane Central Register ◽  
Renal Transplant Recipients ◽  
All Cause Mortality

Objective: People with nondialysis-dependent chronic kidney disease (CKD) and renal transplant recipients (RTRs) have compromised physical function and reduced physical activity (PA) levels. Whilst established in healthy older adults and other chronic diseases, this association remains underexplored in CKD. We aimed to review the existing research investigating poor physical function and PA with clinical outcome in nondialysis CKD. Data sources: Electronic databases (PubMed, MEDLINE, EMBASE, Web of Science, Cochrane Central Register of Controlled Trials) were searched until December 2017 for cohort studies reporting objective or subjective measures of PA and physical function and the associations with adverse clinical outcomes and all-cause mortality in patients with nondialysis CKD stages 1–5 and RTRs. The protocol was registered on the International Prospective Register of Systematic Reviews (PROSPERO) (CRD42016039060). Review methods: Study quality was assessed using the Newcastle-Ottawa Scale and the Agency for Healthcare and Research Quality (AHRQ) standards. Results: A total of 29 studies were included; 12 reporting on physical function and 17 on PA. Only eight studies were conducted with RTRs. The majority were classified as ‘good’ according to the AHRQ standards. Although not appropriate for meta-analysis due to variance in the outcome measures reported, a coherent pattern was seen with higher mortality rates or prevalence of adverse clinical events associated with lower PA and physical function levels, irrespective of the measurement tool used. Sources of bias included incomplete description of participant flow through the study and over reliance on self-report measures. Conclusions: In nondialysis CKD, survival rates correlate with greater PA and physical function levels. Further trials are required to investigate causality and the effectiveness of physical function and PA interventions in improving outcomes. Future work should identify standard assessment protocols for PA and physical function.

scholarly journals Physical activity in chronic kidney disease and the EXerCise Introduction To Enhance trial

2020 ◽  
Vol 35 (Supplement_2) ◽  
pp. ii18-ii22 ◽  
Author(s):  
Francesca Mallamaci ◽  
Anna Pisano ◽  
Giovanni Tripepi
Keyword(s):  
Physical Activity ◽  
Chronic Kidney Disease ◽  
Kidney Disease ◽  
Clinical Outcomes ◽  
Sedentary Lifestyle ◽  
Public Health Problem ◽  
Epidemiological Studies ◽  
Dialysis Patients ◽  
Increased Risk ◽  
Reduced Physical Activity

Abstract It is well known from observational studies that sedentary lifestyle and reduced physical activity are common in dialysis and chronic kidney disease (CKD) patients and associate with an increased risk of morbidity and mortality in this patient population. Epidemiological studies indicate that CKD patients undergo physical activity ~9 days/month and 43.9% of dialysis patients report not exercising at all. On the basis of awareness about the strong link between sedentary lifestyle and adverse clinical outcomes, the National Kidney Foundation and Kidney Disease: Improving Global Outcomes have provided specific recommendations for physical activity in patients with kidney disease. Given the fact that CKD is a public health problem and it is still debated which type of exercise should be prescribed in these patients, this review focuses on the most robust evidence accumulated so far on the beneficial effect of various types of physical exercise on clinical outcomes in CKD and dialysis patients. This review does not treat this very important topic in another CKD category of patients, such as kidney-transplanted patients, for whom a special issue should be dedicated.

scholarly journals Musculoskeletal pain reported by mobile patients with chronic kidney disease

2020 ◽  
Vol 13 (5) ◽  
pp. 813-820
Author(s):  
Stig Molsted ◽  
Inge Eidemak
Keyword(s):  
Physical Activity ◽  
Chronic Kidney Disease ◽  
Kidney Disease ◽  
General Population ◽  
Physical Function ◽  
Musculoskeletal Pain ◽  
Chair Stand ◽  
Stand Test ◽  
Chair Stand Test ◽  
The Impact

Abstract Background Musculoskeletal pain has been reported as a clinical problem in patients with chronic kidney disease (CKD). The purpose of this study was to compare the frequency of musculoskeletal pain in patients with CKD and no mobility problems with a general population and to investigate the impact of pain on quality of life (QOL), physical activity and physical function. Methods Patients with CKD Stages 4 and 5 with or without a dialysis treatment and no mobility problems were included. Musculoskeletal pain in the shoulder/neck, back/low back and limbs and level of physical activity were measured using the Danish Health and Morbidity Survey and coded into dichotomous answers. QOL and physical function were measured using the kidney disease QOL questionnaire and the 30-s chair stand test, respectively. Data for the general population were collected in national registers and adjusted for age, gender and region. Results The patients (n = 539) had a mean age of 66 [95% confidence interval (CI) 65–67] years, 62% were men and they were treated with haemodialysis (HD) (n = 281), peritoneal dialysis (n = 62) or without dialysis (n = 196). The frequency of reported musculoskeletal pain in the patients did not exceed pain reported by the general population [e.g. pain in the limbs in patients undergoing HD versus a matched general population, 61% versus 63% (P = 0.533), respectively]. Pain in all measured body sites was associated with reduced QOL [e.g. pain in the limbs associated with a physical component scale β of −8.2 (95% CI −10.3 to −6.0), P < 0.001]. Pain in the limbs was associated with a reduced number of repetitions in the 30-s chair stand test [mean −1.7 (95% CI −3.0 to −0.4), P = 0.009]. Pain in the shoulder/neck was associated with reduced odds of being physically active [odds ratio 0.6 (95% CI 0.4 to 0.9); P = 0.022]. Conclusions Musculoskeletal pain was not more frequently reported by patients with CKD and no mobility problems compared with the general population. However, as musculoskeletal pain was reported by up to two-thirds of the patient sample, healthcare professionals should remember to focus on this issue. The patients’ pain was associated with negative impacts on QOL, level of physical activity and physical function.

Factors Associated With Levels of Physical Activity in Chronic Kidney Disease Patients Undergoing Hemodialysis: The Role of Dialysis Versus Nondialysis Day

2017 ◽  
Vol 14 (9) ◽  
pp. 726-732 ◽  
Author(s):  
Clara Suemi da Costa Rosa ◽  
Danilo Yuzo Nishimoto ◽  
Ismael Forte Freitas Júnior ◽  
Emmanuel Gomes Ciolac ◽  
Henrique Luiz Monteiro
Keyword(s):  
Physical Activity ◽  
Chronic Kidney Disease ◽  
Kidney Disease ◽  
Physical Function ◽  
Demographic Data ◽  
Clinical Status ◽  
Activity Levels ◽  
Factors Associated ◽  
Related Quality ◽  
Health Related

Background:Patients on hemodialysis (HD) report lower physical activity (PA) levels. We analyzed factors associated with low levels of PA in patients with chronic kidney disease (CKD) and compared PA on HD day and non-HD.Methods:79 patients wore an accelerometer and were classified according to time spent on moderate-to-vigorous PA (MVPA). Demographic data, BMI, comorbidities, clinical status, and health-related quality of life (HRQoL) were checked for association with PA. In addition, PA level was compared between days of HD and non-HD.Results:Accelerometer compliance was 78.5% [33 men and 29 women (53.96 ± 15.71 yrs) were included in analysis]. 35.5% of sample achieved ≥150min/week on MVPA. Lower MVPA was associated with older age (OR = 5.80, 95% CI = 1.11 to 30.19, P = .04), and lower score of physical function HRQoL (OR = 4.33, 95% CI = 1.23 to 15.23, P = .02). In addition, patients spent 9.73% more time on sedentary behavior, 38.9% less on light PA and 74.9% less on MVPA on HD day versus non-HD day.Conclusion:Age and physical function HRQoL were the main factors associated to lower PA levels. In addition, lower time spent on PA during HD day suggest that strategies for increasing physical activity levels during HD day such exercising during HD session could help CKD patients to reach current PA recommendations.

scholarly journals Moderate–Vigorous Physical Activity and Clinical Outcomes in Adults with Nondialysis Chronic Kidney Disease

2021 ◽  
Vol 10 (15) ◽  
pp. 3365
Author(s):  
Ji Kim ◽  
Young Hyun ◽  
Kyu-Beck Lee ◽  
Sung Lee ◽  
Hayne Park ◽  
...  
Keyword(s):  
Physical Activity ◽  
Chronic Kidney Disease ◽  
Kidney Disease ◽  
Clinical Outcomes ◽  
Lower Risk ◽  
Vigorous Physical Activity ◽  
Moderate Amount ◽  
Kaplan Meier ◽  
Cox Proportional Hazard Models ◽  
End Stage

The health benefits of physical activity (PA) are well known. However, the association between an adequate amount of moderate–vigorous PA (MVPA) and clinical outcomes has limited evidence in chronic kidney disease (CKD). We assessed PA using a self-administered questionnaire. The amount of MVPA was categorized into four groups: none, low, moderate, and high (0, <7.5, 7.5–14.9, and 15.0–29.9 metabolic equivalent-hours/week, respectively). We analyzed the association between the amount of MVPA and clinical outcomes. Among a total of 1909 adults with CKD, adults with MVPA showed various beneficial outcomes compared to those with no MVPA in a Kaplan–Meier curve followed over a median of 5.9 years. In multivariable-adjusted Cox proportional hazard models, a low and a moderate amount of MVPA was associated with a lower risk of all-cause death. A moderate amount of MVPA was associated with a lower risk of cardiovascular events. A high amount of MVPA was associated with a lower risk of end-stage kidney disease in ESKD in 1324 adults with eGFR <60 mL/min/1.73 m2. Age and sex modified the relationships between MVPA and clinical outcomes. MVPA is associated with various beneficial outcomes across the amount of MVPA. PA plans should be tailored for individual adults with CKD.

Physical activity in patients with pre-dialysis chronic kidney disease is related to physical function

2020 ◽  
Vol 24 (12) ◽  
pp. 1189-1190
Author(s):  
Chiharu Hotta ◽  
Koji Hiraki ◽  
Kazuhiro P. Izawa ◽  
Tsutomu Sakurada ◽  
Yugo Shibagaki
Keyword(s):  
Physical Activity ◽  
Chronic Kidney Disease ◽  
Kidney Disease ◽  
Physical Function

scholarly journals Assessing physical activity and function in patients with chronic kidney disease: a narrative review

2020 ◽  
Author(s):  
Esmée A Bakker ◽  
Carmine Zoccali ◽  
Friedo W Dekker ◽  
Thijs M H Eijsvogels ◽  
Kitty J Jager
Keyword(s):  
Physical Activity ◽  
Chronic Kidney Disease ◽  
Kidney Disease ◽  
Physical Function ◽  
Severe Disabilities ◽  
Measurement Instruments ◽  
Beneficial Effects ◽  
Physical Activity And Exercise ◽  
Method Accuracy ◽  
And Function

Abstract Physical activity potentially improves health outcomes in patients with chronic kidney disease (CKD) and recipients of kidney transplants. Although studies have demonstrated the beneficial effects of physical activity and exercise for primary and secondary prevention of non-communicable diseases, evidence for kidney patients is limited. To enlarge this evidence, valid assessment of physical activity and exercise is essential. Furthermore, CKD is associated with a decline in physical function, which may result in severe disabilities and dependencies. Assessment of physical function may help clinicians to monitor disease progression and frailty in patients receiving dialysis. The attention on physical function and physical activity has grown and new devices have been developed and (commercially) launched on the market. Therefore the aims of this review were to summarize different measures of physical function and physical activity, provide an update on measurement instruments and discuss options for easy-to-use measurement instruments for day-to-day use by CKD patients. This review demonstrates that large variation exists in the different strategies to assess physical function and activity in clinical practice and research settings. To choose the best available method, accuracy, content, preferable outcome, necessary expertise, resources and time are important issues to consider.

scholarly journals Plasma natriuretic peptide level is an independent determinant of major clinical outcomes in atrial fibrillation patients without heart failure: the Fushimi AF Registry

2020 ◽  
Vol 41 (Supplement_2) ◽  
Author(s):  
Y Hamatani ◽  
M Iguchi ◽  
Y Aono ◽  
K Ishigami ◽  
S Ikeda ◽  
...  
Keyword(s):  
Heart Failure ◽  
Atrial Fibrillation ◽  
Chronic Kidney Disease ◽  
Kidney Disease ◽  
Clinical Outcomes ◽  
Prognostic Marker ◽  
Oral Anticoagulants ◽  
Systemic Embolism ◽  
The Mean

Abstract Background Atrial fibrillation (AF) increases the risk of death, stroke/systemic embolism and heart failure (HF). Plasma natriuretic peptide (NP) level is an important prognostic marker in HF patients. However, little is known regarding the prognostic significance of plasma NP level in AF patients without HF. Purpose The aim of this study is to investigate the relationship between plasma NP level and clinical outcomes such as all-cause death, stroke/systemic embolism and HF hospitalization during follow-up period in AF patients without HF. Methods The Fushimi AF Registry is a community-based prospective survey of AF patients in our city. The inclusion criterion of the registry is the documentation of AF at 12-lead electrocardiogram or Holter monitoring at any time, and there are no exclusion criteria. We started to enroll patients from March 2011, and follow-up data were available for 4,466 patients by the end of November 2019. From the registry, we excluded 1,220 patients without a pre-existing HF (defined as having one of the following; prior hospitalization for HF, New York Heart Association class ≥2, or left ventricular ejection fraction &lt;40%). Among 3,246 AF patients without HF, we investigated 1,189 patients with the data of plasma BNP (n=401) or N-terminal pro-BNP (n=788) level at the enrollment. We divided the patients according to the quartile of each plasma BNP or NT-pro BNP level and compared the backgrounds and outcomes between these 4 groups stratified by plasma NP level. Results Of 1,189 patients, the mean age was 72.1±10.2 years, 454 (38%) were female and 684 (58%) were paroxysmal AF. The mean CHADS2 and CHA2DS2-VASc score were 1.6±1.1 and 2.9±1.5, respectively. Oral anticoagulants were prescribed in 671 (56%) at baseline. The median (interquartile range) BNP and N-terminal pro-BNP level were 84 (38, 176) and 500 (155, 984) pg/ml, respectively. Patients with high plasma NP level were older, and demonstrated lower prevalence of paroxysmal AF, higher CHADS2 and CHA2DS2-VASc scores and higher prevalence of chronic kidney disease and oral anticoagulants prescription (all P&lt;0.01). A total of 165 all-cause death, 114 stroke/systemic embolism and 103 HF hospitalization occurred during the median follow-up period of 5.0 years. Kaplan-Meier curves demonstrated that higher plasma NP level was significantly associated with the incidences of all-cause death, stroke/systemic embolism and HF hospitalization in AF patients without HF (Figure 1A). Multivariable Cox regression analysis revealed that plasma NP level could stratify the risk of clinical outcomes even after adjustment by type of AF, CHA2DS2-VASc score, chronic kidney disease and oral anticoagulant prescription (Figure 1B). Conclusion Plasma NP level is a significant prognostic marker for all-cause death, stroke/systemic embolism and HF hospitalization in AF patients without HF, suggesting the importance of measuring plasma NP level in AF patients even without HF. Figure 1 Funding Acknowledgement Type of funding source: None

Sign in / Sign up

Export Citation Format

Share Document