Abstract: SA-PO863
The Association of Physical Activity with Poor Health Outcomes in Patients with Advanced CKD
Session Information
- CKD: Socioeconomic Context and Mobile Apps
November 09, 2019 | Location: Exhibit Hall, Walter E. Washington Convention Center
Abstract Time: 10:00 AM - 12:00 PM
Category: CKD (Non-Dialysis)
- 2101 CKD (Non-Dialysis): Epidemiology, Risk Factors, and Prevention
Authors
- Brar, Ranveer Singh, Chronic Disease Innovation Centre, Winnipeg, Manitoba, Canada
- Bohm, Clara, Chronic Disease Innovation Centre, Winnipeg, Manitoba, Canada
- Rigatto, Claudio, Chronic Disease Innovation Centre, Winnipeg, Manitoba, Canada
- Komenda, Paul, Chronic Disease Innovation Centre, Winnipeg, Manitoba, Canada
- Prasad, Bhanu, Regina Qu'Appelle Health Region, Winnipeg, Manitoba, Canada
- Tangri, Navdeep, Chronic Disease Innovation Centre, Winnipeg, Manitoba, Canada
Background
Chronic kidney disease (CKD) disproportionately affects older adults, and is known to be associated with low physical activity levels. In the general population, low physical activity level is associated with an increased risk of all-cause mortality and other adverse outcomes. This association also exists in patients with moderate CKD and those on dialysis; however this has yet to be explored in patients with advanced CKD (G4-G5). The primary aims of this study were to determine the association of physical activity level with all-cause mortality, as well as the assocation with progression to dialysis and future fall risk in patients with advanced CKD.
Methods
Individuals with advanced CKD (G4-G5) were identified from the CanFIT cohort, a multicenter, prospective study of frailty, between October 2012 and July 2018 (n=592). Self-reported physical activity was assessed at baseline by the Physical Activity Scale for the Elderly (PASE). PASE scores were stratified by tertiles (0-40 (Low Activity); 41-90 (Light Activity); >90 (Moderate-High activity). Baseline clinical characteristics and comorbidities were obtained through chart review. Our primary outcome of all-cause mortality and secondary outcome of progression to dialysis were analyzed using Cox proportional hazard models. Logistic regression was performed for our secondary outcome of future fall risk.
Results
We had 121 participants die during the study (mean follow-up 1193 days) and 215 participants progressed to dialysis (mean follow-up 896 days). Compared with low physical activity level, higher levels of physical activity were associated with a reduction in all-cause mortality (HR 0.56 [95% CI: 0.33-0.94]) when adjusted for age, sex, and comorbidities. Of 472 participants with follow-up assessing falls, 131 (28%) had a fall event. Level of baseline physical activity did not predict progression to dialysis or future falls.
Conclusion
In advanced CKD, higher levels of physical activity were associated with a 50% reduction in all-cause mortality. Although progression to dailysis and future fall risk were not associated with baseline physical activity level, the impact in the change of physical activity level on these outcomes requires further investigation.