BackgroundThis study aimed to assess the reliability and validity of the International Physical Activity Questionnaire (IPAQ) in Chinese maintenance hemodialysis (MHD) patients. These findings could help increase the validity of future MHD physical activity (PA) studies, both within China and throughout the world.Material/MethodsA multicenter prospective cohort study including 320 patients was conducted in Zhejiang, China. Patients’ PA was assessed by analyzing answers to the International Physical Activity Questionnaire Chinese version (IPAQ-C) during hemodialysis, and comparing the results with 1 week of pedometer data.ResultsThe IPAQ-C had good internal reliability and test-retest stability (total ICC=0.84, 95%CI 0.76–0.89), and all PA-related variables correlated significantly between the IPAQ-C and pedometer data (r=0.280–0.561). When stratified by sex, there was a significant correlation for total PA (Spearman r=0.468 p<0.01 for women; Spearman r=0.603 p<0.01 for men) and intensity between pedometry and IPAQ-C. After adjustment for several factors, no relationships were observed among women, but significant relationships existed for men (total partial r=0.486 p<0.05, moderate PA partial r=0.358 p<0.05, walking partial r=0.465 p<0.05, vigorous PA not significant).ConclusionsThis is the first study to test the reliability and validity of the IPAQ-C in Chinese MHD patients. Overall, we conclude that IPAQ-C is a simple and reliable instrument for measuring PA in Chinese MHD patients, but possible sex and age bias should be considered when interpreting these results.

BackgroundSomatic symptoms are commonly reported by patients on maintenance hemodialysis. Based on evidence that exercise can improve psychological state among the general population, we aimed to evaluate the effects of physical activity on somatic symptoms specifically in this clinical population.MethodsThis was a multicenter, cross-sectional study that included patients receiving hemodialysis treatment ≥3 times per week for > 3 months, aged 18 years or older, and who were willing to complete our study questionnaires and wear a pedometer; they were recruited from four hemodialysis centers in Zhejiang, China. Physical activity was quantified using pedometer data, with somatic symptoms quantified using the Symptom Checklist-90 (SCL-90). Hemodialysis information and blood laboratory tests were obtained from patients’ medical record. The score on the somatic dimension of the SCL-90 (S1-score) subdivided into tertiles for analysis: ≤1.17 (Q1), 1.17–1.58 (Q2) and ≥ 1.58 (Q3). A multivariate logistic regression analysis was performed to estimate the crude and adjusted odd ratios (ORs) and 95% confidence intervals (CIs) for the S1- somatic score according to the physical activity level during the last week. For this analysis, patients were stratified in a high and low exercise group using a cutoff of 3000 MET-min/week. Model 1 was adjusted for skinfold thickness of the triceps, upper arm circumference, grip strength, 5-m walking time, and 30-s sit-to-stand test. In model 2, we further adjusted for the leukocyte count, high-sensitivity C-reactive protein level, and albumin level.ResultsAfter screening, 320 patients were enrolled into the study group (37.50% male, average age of 58.60 ± 14.2 years and mean average number of steps per day of 3725.92 ± 2663.47). The S1-score (1.51 ± 0.39) was significantly higher for patients than for the normal reference population (P < 0.001). As the S1-score increased, the average number of steps per day decreased, both on dialysis and non-dialysis days. Total physical activity, measured by pedometry, showed the best correlation to S1 scores (r = − 0.813; P < 0.01). The OR of a high S1-score was 1.97 [95% CI, 0.63–4.08] for patients in the low physical activity group.ConclusionHigher S1 (somatic symptom) score was related to low physical activity among patients on maintenance hemodialysis.

Background Worldwide, the treatment of patients with chronic kidney disease (CKD) remains a challenge as warfarin treatment can be associated with severe adverse events related to bleeding. Alternative anticoagulants that can be used in CKD remain to be identified. This study aimed to compare the effects of indobufen, a new antiplatelet agent, with warfarin in a rat model of adenine-induced CKD. Material/Methods Forty-eight male Wistar rats were treated with intragastric adenine to create the rat model of CKD and were divided into four groups: an untreated control group (N=12), a group treated with dimethyl sulfoxide (DMSO) (N=12), a group treated with indobufen, (N=12) and a group treated with warfarin (N-12). Treatment was given for 4 weeks and 8 weeks. Kidney histology was performed, and the degree of fibrosis was quantified using Masson trichrome staining. Results In the rat model of adenine-induced CKD, Masson trichrome staining showed that the degree of kidney fibrosis in the indobufen group (26%) was significantly reduced (p<0.05) when compared the DMSO group (58%) and the warfarin group (49%). Kidney fibrosis was associated with upregulation of 6-keto-PGI2/TXB2 in the rat kidney tissue. Conclusions In a rat model of adenine-induced CKD, preliminary findings showed that indobufen was associated with reduced kidney fibrosis when compared with warfarin.

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