Physical Activity in ESRD

Seliger, Stephen L.

doi:10.2215/cjn.11041012

Cited by 2 publications

(4 citation statements)

References 25 publications

(19 reference statements)

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“…Walking was the activity most frequently reported by our study participants, as in a recent study of CKD patients, and growing evidence from both CKD and general population studies shows that even small amounts of activity, as opposed to remaining sedentary, can have multifactorial health benefits . The multiple physiologic effects of physical activity, including potential effects on levels of inflammation, suggest pathways by which greater physical activity may be associated with lower risk of mortality . Physical activity can mean any movement above resting level, but we fully support the goal of increased understanding of the relative benefits of different activity and exercise modalities, frequencies and intensities so that the most effective individualized approaches can be developed for all CKD patients .…”

Section: Discussionsupporting

confidence: 69%

“…The activity instrument we relied on uses self‐report, a method that is subject to recall and reporting biases even when well‐trained interviewers administer the questions as in this study . Assessment of usual physical activity by accelerometer or pedometer may be considered a more objective method for measuring activity . However, these devices are typically worn over short time periods, while self‐report measures can provide an overview of ongoing, usual behaviors .…”

Section: Discussionmentioning

confidence: 99%

“…However, these devices are typically worn over short time periods, while self‐report measures can provide an overview of ongoing, usual behaviors . Although the potential limitation of self‐report must be acknowledged, in large cohorts the most feasible method for measuring physical activity is the use of questionnaires that can survey a range of activities that individuals may have engaged in within a fixed time period …”

Section: Discussionmentioning

confidence: 99%

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Lower C‐reactive protein and better hemodialysis survival are associated with regular exercise activity: Longitudinal outcomes from the ACTIVE‐ADIPOSE special study

Kutner¹,

Zhang

Huang

et al. 2016

Hemodialysis International

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Introduction Cross-sectional and longitudinal studies in the general population have shown that a physically active lifestyle may have anti-inflammatory properties, but evidence from studies conducted with maintenance hemodialysis (HD) patients is limited. Methods A multicenter prospective cohort of 755 HD participants aged 20-92 was evaluated in a USRDS special study 2009-2013. Kilocalories/week (kcal/week) of leisure time physical activity (LTPA) was estimated from the Minnesota Leisure Time Activity questionnaire. Predialysis serum samples were obtained concurrent with LTPA report date. Generalized estimating equations (GEE) examined association of participants' LTPA and log-normalized CRP across 24 months. Cox proportional hazards models investigated LTPA and survival over a median follow-up of 718 days. Findings Baseline median CRP concentration was lower for participants with 500+ kcal/week LTPA vs. those with <500 kcal/week LTPA (3.4 mg/L vs. 4.6 mg/L; P = 0.03). Participants who reported lower LTPA (<500 kcal/week) at both baseline and 12 months had a borderline significant increase in CRP concentration (within-group change 4.8 [1.9-10.4] to 5.8 [1.6-15.7]; P = 0.08). Lower LTPA was associated with higher log CRP over 24 months in adjusted GEE analyses (β coefficient = 0.16 [95% CI 0.02-0.31]; P = 0.03). 67/364 (18%) and 43/391 (11%) deaths occurred, respectively, among participants reporting <500 vs. 500+ kcal/week LTPA [adjusted mortality hazard ratio 1.63 (CI, 1.07, 2.47)]. Discussion The data suggest that increased estimated levels of LTPA, a physical activity/exercise opportunity widely applicable to HD patients, may be associated with lower CRP concentration as well as better survival outcome.

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Section: Discussionsupporting

confidence: 69%

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

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Lower C‐reactive protein and better hemodialysis survival are associated with regular exercise activity: Longitudinal outcomes from the ACTIVE‐ADIPOSE special study

Kutner¹,

Zhang

Huang

et al. 2016

Hemodialysis International

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“…While physical activity is widely accepted as an important modifiable risk factor for cardiovascular disease, the association is not well established in kidney disease. A number of observational and interventional studies have examined the risks and benefits of physical activity among patients undergoing maintenance dialysis 21–24. However, previous studies of incident kidney disease are limited and have reported inconsistent results.…”

Section: Discussionmentioning

confidence: 99%

The association of exercise and sedentary behaviours with incident end-stage renal disease: the Southern Community Cohort Study

et al. 2019

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ObjectiveTo examine whether lifestyle factors, including sedentary time and physical activity, could independently contribute to risk of end-stage renal disease (ESRD).Study designCase-cohort study.SettingSouth-eastern USA.ParticipantsThe Southern Community Cohort Study recruited ~86 000 black and white participants from 2002 to 2009. We assembled a case cohort of 692 incident ESRD cases and a probability sample of 4113 participants.PredictorsSedentary time was calculated as hours/day from daily sitting activities. Physical activity was calculated as metabolic equivalent (MET)-hours/day from engagement in light, moderate and vigorous activities.OutcomesIncident ESRD.ResultsAt baseline, among the subcohort, mean (SD) age was 52 (8.6) years, and median (25th, 75th centile) estimated glomerular filtration rate (eGFR) was 102.8 (85.9–117.9) mL/min/1.73 m2. Medians (25th–75th centile) for sedentary time and physical activity were 8.0 (5.5–12.0) hours/day and 17.2 (8.7–31.9) MET-hours/day, respectively. Median follow-up was 9.4 years. We observed significant interactions between eGFR and both physical activity and sedentary behaviour (p<0.001). The partial effect plot of the association between physical activity and log relative hazard of ESRD suggests that ESRD risk decreases as physical activity increases when eGFR is 90 mL/min/1.73 m2. The inverse association is most pronounced at physical activity levels >27 MET-hours/day. High levels of sitting time were associated with increased ESRD risk only among those with reduced kidney function (eGFR ≤30 mL/min/1.73 m2); this association was attenuated after excluding the first 2 years of follow-up.ConclusionsIn a population with a high prevalence of chronic kidney disease risk factors such as hypertension and diabetes, physical activity appears to be associated with reduced risk of ESRD among those with preserved kidney function. A positive association between sitting time and ESRD observed among those with advanced kidney disease is likely due to reverse causation.

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Physical Activity in ESRD

Cited by 2 publications

References 25 publications

Lower C‐reactive protein and better hemodialysis survival are associated with regular exercise activity: Longitudinal outcomes from the ACTIVE‐ADIPOSE special study

Lower C‐reactive protein and better hemodialysis survival are associated with regular exercise activity: Longitudinal outcomes from the ACTIVE‐ADIPOSE special study

The association of exercise and sedentary behaviours with incident end-stage renal disease: the Southern Community Cohort Study

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