Determining factors of functioning in hemodialysis patients using the international classification of functioning, disability and health

Abstract

Background Hemodialysis (HD) treatment affects functioning, physical activity level, clinical biomarkers, and body composition. However, the association between these variables with functioning, considering International Classification of Functioning, Disability and Health (ICF) domains remains unclear. Thus, the aim of this study was to investigate the possible association between physical activity, biomarkers, and body composition with functioning in HD patients in reference to the ICF. Methods Eighty HD patients performed different tests grouped according to ICF domain: Body structure and function – handgrip strength (HS), 5-repetition sit-to-stand test, and 60-s sit-to-stand test (5-STS, 60-STS, respectively); Activity – short physical performance battery (SPPB); and Participation – participation scale questionnaire. Physical activity [Human Activity Profile questionnaire (HAP)], body composition (Dual-energy X-ray absorptiometry), Parathormone (PTH), and alkaline phosphatase were analyzed as possible variables associated with ICF domains. Data analyses were performed using simple and multiple regression models adjusted for age, duration of HD, and diuresis volume. Results In the body structure and function domain, appendicular lean mass, PTH level, and age were associated with HS (R2 = 0.558); HAP and PTH were associated with 5-STS (R2 = 0.263); and HAP, PTH, duration of HD, and age were associated with 60-STS (R2 = 0.337). In the activity domain, HAP, PTH, alkaline phosphatase, duration of HD, age, and body fat were associated with SPPB (R2 = 0.689). Finally, only HAP was associated with the participation scale (R2 = 0.067). Conclusion Physical activity and PTH levels are determinant protagonists of functioning in all ICF domains in hemodialysis patients.

Effects of a Combined Intradialytic Exercise Training Program on Functional Capacity and Body Composition in Kidney Transplant Candidates

“…In the study of Kim et al [ 5 ], STS showed unsatisfactory results for HD adult patients and did not significantly correlate with daily physical activity, compared to 6-MWD. While in the study of Santos et al [ 40 ] age and duration of HD were found to affect the 60-s-STS performance.…”

High level of soluble tumor necrosis factor receptors is a contributing factor of lower diuresis volume in hemodialysis patients: An exploratory study

“…Simple linear regression was utilized for independent variables with p < 0.20 in correlation tests (Pearson or Spearman), and stepwise multiple linear regression models were formulated for outcomes with p < 0.10 in simple linear regression [19]. The signi cance level was set at 5%, and adjustments for age, fractional urea clearance, and duration of HD were incorporated into the models [21].…”

“…Linearity was assessed through scatter plots of independent variables and residuals, while the distribution of residuals was inspected via histograms [21]. Homoscedasticity was con rmed with a scatter plot where residuals exhibited an even distribution along the regression line [21]. The absence of multicollinearity was ascertained by variance in ation factor (VIF) values below 10.0 [21].…”

“…Homoscedasticity was con rmed with a scatter plot where residuals exhibited an even distribution along the regression line [21]. The absence of multicollinearity was ascertained by variance in ation factor (VIF) values below 10.0 [21]. Additionally, the examination of the auto-correlation of variables was done using the Durbin-Watson test, with values between 1.5 and 2.5 indicating no autocorrelation in the data [21].…”

“…The experimental design involved two sessions conducted on dialysis days, with data collected both before and after the HD sessions. Initial Session: The anamnesis of HD patients included an assessment of personal and disease-related factors, such as gender, age, comorbidities, duration of HD, and diuresis volume [21].…”