1. Association of Physical Activity and Poor Health Outcomes in Patients With Advanced CKD
- Author
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Ranveer Brar, Clara Bohm, Claudio Rigatto, Christie Rampersad, Paul Komenda, Kelsey Connelly, Navdeep Tangri, and Bhanu Prasad
- Subjects
Male ,medicine.medical_specialty ,medicine.medical_treatment ,Population ,030232 urology & nephrology ,03 medical and health sciences ,0302 clinical medicine ,Quality of life ,Risk Factors ,Internal medicine ,Outcome Assessment, Health Care ,Humans ,Medicine ,Prospective Studies ,030212 general & internal medicine ,Renal Insufficiency, Chronic ,education ,Prospective cohort study ,Exercise ,Dialysis ,Aged ,Sedentary lifestyle ,Aged, 80 and over ,education.field_of_study ,business.industry ,Proportional hazards model ,Middle Aged ,medicine.disease ,Comorbidity ,Renal Replacement Therapy ,Nephrology ,Disease Progression ,Female ,business ,Follow-Up Studies ,Glomerular Filtration Rate ,Kidney disease - Abstract
Rationale and objective Chronic kidney disease (CKD) is associated with declining physical function and activity. In the general population, lower physical activity is associated with poorer quality of life and greater all-cause mortality. The aim of this study was to assess if lower physical activity levels are associated with adverse health outcomes in patients with advanced CKD. Study design A multi-center prospective cohort study. Setting and participants 579 adult patients with CKD Stages G4-G5 treated at four Canadian multidisciplinary kidney health clinics between 2012 and 2018. Exposures Patient-reported measures of physical activity using the Physical Activity Scale for the Elderly (PASE) questionnaire and subsequently stratified PASE scores into tertiles. Outcomes All-cause mortality, progression to kidney failure, and future falls. Analytical approach Outcomes were analyzed using time-dependent proportional hazards models and logistic regression models. Results In 1193 days of follow up, 118 patients died, 204 progressed to dialysis, and 129 reported a fall. When compared to low physical activity, higher levels of physical activity were associated with a 52% lower all-cause mortality (adjusted HR 0.48, 95% CI 0.27-0.85) in models adjusted for age, sex, and comorbidity. No associations were detected between higher levels of physical activity and either slower progression to kidney failure or a lower rate of future falls. Limitations Physical activity and falls were self-reported. Our population was largely Caucasian which may limit generalizability. Findings were observational and do not indicate whether interventions targeting physical activity may affect adverse health outcomes. Conclusions Higher levels of physical activity were associated with about 50% lower all-cause mortality in the advanced CKD population. These findings are consistent with a potential benefit from maintained physical activity as patients approach kidney failure.
- Published
- 2021