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Abstract: TH-PO253

Physical Activity in Patients on Hemodialysis and Its Relation to Fatigue and Depression

Session Information

Category: Dialysis

  • 701 Dialysis: Hemodialysis and Frequent Dialysis

Authors

  • Brys, Astrid, Università Cattolica del Sacro Cuore, Rome, Rome, Italy
  • Bossola, Maurizio, Università Cattolica del Sacro Cuore, Rome, Rome, Italy
  • Lenaert, Bert, Faculty of Psychology and Neuroscience, Maastricht University, Maastricht, Netherlands
  • Biamonte, Filippo, Università Cattolica del Sacro Cuore, Rome, Rome, Italy
  • Gambaro, Giovanni, Università Cattolica del Sacro Cuore, Rome, Rome, Italy
  • Di stasio, Enrico, Università Cattolica del Sacro Cuore, Rome, Rome, Italy
Background

Hemodialysis (HD) patients are less active than healthy sedentary adults. Fatigue and depression are considered main reasons for physical inactivity in HD patients and are associated with impaired quality of life (QOL). A better understanding of the relation between fatigue, depression and physical activity (PA) is crucial in order to develop effective therapies and improve QOL. Measurement of PA is however challenging, as it is usually assessed by subjective self-report questionnaires. Recently, objective assessment of PA with motion sensors has gained interest. Therefore, we aimed to objectively measure HD patients’ daily PA and to explore its relation with fatigue and depression.

Methods

PA was assessed in 37 HD patients (mean age 61 years) based on the daily step count measured with the SenseWearTM Armband for 7 days. The Fatigue Severity Scale (FSS) and Beck Depression Inventory-II (BDI) were administered to evaluate fatigue and depressive mood.

Results

Median physical activity was 2247 steps a day, [IQR:614-4363], and no significant differences in PA were observed between treatment and non-treatment days.
PA per measurement day did not correlate with fatigue experience (rs=0.04, p=0.499), and did not significantly differ between patients that were categorized as fatigued (n=23, FSS≥4) or not (n=14, FSS<4) (Fig.1a: p’s 0.745-0.988; Cohen’s d's <0.20).
In contrast, PA per measurement day significantly though inversely correlated with depressive mood (rs=-0.22, p<0.001) and significantly differed between high-depressed (n=18, BDI>13) and low-depressed subjects (n=19, BDI≤13) (p=0.004), who made on average 1.7 times more steps a day than their high-depressed counterparts. The main differences in PA were observed on non-treatment days (Fig.1b: p’s 0.017-0.105; Cohen’s d's 0.57-0.90).

Conclusion

Objective assessment of PA with motion sensors is feasible in HD patients. Depressive mood, in contrast to fatigue experience, seems to be associated with PA. These findings may help to increase awareness about the need for intervention trials to assess the effect on PA in HD patients by improving their mood, or vice versa.