ASN's Mission

To create a world without kidney diseases, the ASN Alliance for Kidney Health elevates care by educating and informing, driving breakthroughs and innovation, and advocating for policies that create transformative changes in kidney medicine throughout the world.

learn more

Contact ASN

1401 H St, NW, Ste 900, Washington, DC 20005

email@asn-online.org

202-640-4660

The Latest on Twitter

Kidney Week

Abstract: TH-PO310

Utility of Regular Management of Physical Activity and Physical Function in Hemodialysis Patients

Session Information

Category: Dialysis

  • 701 Dialysis: Hemodialysis and Frequent Dialysis

Authors

  • Yamamoto, Shohei, Kitasato University Graduate School of Medical Sciences, Sagamihara, Japan
  • Matsuzawa, Ryota, Kitasato University Hospital, Sagamihara, Japan
  • Abe, Yoshifumi, Kitasato University Graduate School of Medical Sciences, Sagamihara, Japan
  • Harada, Manae, Kitasato University Graduate School of Medical Sciences, Sagamihara, Japan
  • Watanabe, Takaaki, Kitasato University Graduate School of Medical Sciences, Sagamihara, Japan
  • Suzuki, Yuta, Kitasato University Graduate School of Medical Sciences, Sagamihara, Japan
  • Kamiya, Kentaro, Kitasato University Graduate School of Medical Sciences, Sagamihara, Japan
  • Yoshida, Atsushi, Sagami Circulatory Organ Clinic, Sagamihara, Japan
  • Matsunaga, Atsuhiko, Kitasato University Graduate School of Medical Sciences, Sagamihara, Japan
Background

Several clinical practice guidelines recommend regular assessment of physical activity and physical function as part of routine care in hemodialysis patients. However, there is no clear evidence to support these recommendations. We investigated whether the proportion of attendance at a regular program for management of physical activity and physical function can predict all-cause mortality and cardiovascular events in hemodialysis patients.

Methods

This retrospective cohort study consisted of 266 hemodialysis patients participating in the management program at least once. Participants were tracked for 3 years after their first attendance at the management program to determine their attendance proportion. The main study outcomes included all-cause mortality and a composite of fatal and nonfatal cardiovascular events.

Results

Median patient age was 64.5 ( interquartile range, 56.8–72.0 ) years, 45% were women, and the median time on hemodialysis was 35.5 ( interquartile range, 12.0–114.3 ) months at baseline. Sixty-five patients died over a median follow-up of 79 months ( Figure 1A ). The incidence of cardiovascular events was 60 over a median follow-up of 68 months ( Figure 1B ). Even after adjusting for any of the prognostic models, participants who attended ≦75% of sessions ( n=140 ) had higher risks of mortality ( hazard ratio (HR), 1.79 ; 95% confidence interval (CI) : 1.00–3.36 ; P = 0.049 ) and cardiovascular events ( HR, 1.84 ; 95% CI : 1.07–3.48 ; P=0.03 ) than those attending >75% of sessions ( n=126 ).

Conclusion

Hemodialysis patients in whom physical activity and physical function could be assessed more regularly had better prognosis than those with only intermittent assessment.

Figure 1. Kaplan–Meier analysis of survival (A) and cardiovascular events (B) in 266 patients undergoing hemodialysis.
The High attendance group ( attended >75% of all available sessions in the management program ) had significantly better survival and lower incidence of cardiovascular disease than the Low attendance group ( ≤75% attendance ).