Physical Functioning and Exercise Capacity in Patient on Dialysis

Johansen, Kirsten L.

doi:10.1016/s1073-4449(99)70032-4

Cited by 122 publications

(76 citation statements)

References 35 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…This finding is supported by Dhingra et al (2), who reported that prevalent patients who had ESRD and used an AVF were more likely to be ambulatory than patients who used a CVC. Factors that contribute to reduced physical activity among dialysis patients include uremic myopathy and anemia of chronic disease (19). Better dialysis adequacy, conferred by AVF use, may lead to greater uremia reduction and reduced anemia compared with CVC use (20,21).…”

Section: Discussionmentioning

confidence: 99%

Association of Initial Hemodialysis Vascular Access with Patient-Reported Health Status and Quality of Life

Wasse¹,

Kutner²,

Zhang³

et al. 2007

Clinical Journal of the American Society of Nephrology

View full text Add to dashboard Cite

Background: Although the arteriovenous fistula (AVF) is the recommended form of vascular access for patients with ESRD, its impact on patient perception of health status, quality of life (QOL), or satisfaction is unknown.Design, setting, participants, and measurements: This study compared patient-reported health status and QOL scores and vascular access type among a national random sample of 1563 patients at dialysis initiation and day 60 of ESRD during 1996 to 1997. Patients were stratified into five categories: AVF at first dialysis and day 60 of ESRD, arteriovenous graft (AVG) at first dialysis and day 60, central venous catheter (CVC) at first dialysis and AVF at day 60, CVC at first dialysis and AVG at day 60, and CVC at first dialysis and day 60.Results: Ten percent (n ‫؍‬ 154) of patients had an AVF, 21% (n ‫؍‬ 326) had an AVG, and 69% (n ‫؍‬ 1083) had a CVC at dialysis initiation; those who were most likely to use an AVF were white and male. After statistical adjustment, patients with persistent AVF use reported greater physical activity and energy, better emotional and social well-being, fewer symptoms, less effect of dialysis and burden of kidney disease, and better sleep compared with patients with persistent CVC use, whereas measures such as cognitive and sexual function did not differ by access type.Conclusions: Compared with persistent CVC use, early persistent AVF use is associated with the perception of improved health status and QOL among patients with ESRD. Future longitudinal studies may help to clarify further the association between QOL and vascular access.

show abstract

Section: Discussionmentioning

confidence: 99%

Association of Initial Hemodialysis Vascular Access with Patient-Reported Health Status and Quality of Life

Wasse¹,

Kutner²,

Zhang³

et al. 2007

Clinical Journal of the American Society of Nephrology

View full text Add to dashboard Cite

show abstract

“…Patients with advanced chronic kidney disease have reduced CF, attributable to the uremic state and deconditioning imposed by chronic illness (2,3). Although CF improves after transplantation (4), it remains reduced compared with age-and gender-matched control subjects (5).…”

mentioning

confidence: 99%

Cardiorespiratory Fitness Is Related to Physical Inactivity, Metabolic Risk Factors, and Atherosclerotic Burden in Glucose-Intolerant Renal Transplant Recipients

Armstrong¹,

Rakhit²,

Jeffriess³

et al. 2006

Clinical Journal of the American Society of Nephrology

View full text Add to dashboard Cite

The mechanisms of reduced cardiorespiratory fitness (CF) in renal transplant recipients (RTR) have not been studied closely. This study evaluated the relationships between CF and specific cardiovascular risk factors (metabolic syndrome [MS], physical inactivity, myocardial ischemia, and atherosclerotic burden) in glucose-intolerant RTR. Data were recorded on 71 glucose-intolerant RTR (mean age 55 yr; 55% male; median transplant duration 5.7 yr). MS was defined using National Cholesterol Education Programme Adult Treatment Panel III criteria. Resting and exercise stress echocardiography were performed, and myocardial ischemia was identified by new or worsening wall motion abnormalities. Cardiorespiratory fitness was determined using peak oxygen uptake (VO 2 ) by expired gas analysis. Atherosclerotic burden was assessed by carotid intima-media thickness (IMT). Mean peak VO 2 was 19 ؎ 7 ml/kg per min and was significantly lower than predicted peak VO 2 (29 ؎ 6 ml/kg per min; P < 0.001). Patients with MS (63%) had reduced CF (17 ؎ 6 versus 22 ؎ 8 ml/kg per min; P ‫؍‬ 0.001) and were more likely to be physically inactive (76 versus 48%; P ‫؍‬ 0.02). CF was reduced in 14 patients with myocardial ischemia (15 ؎ 3 versus 20 ؎ 7 ml/kg per min; P ‫؍‬ 0.05). CF was positively correlated with male gender, height, and physical activity and inversely correlated with number of MS risk factors and IMT (adjusted R 2 ‫؍‬ 0.66). Carotid IMT added incremental value to clinical variables in determining VO 2 (adjusted R 2 ‫؍‬ 0.65 versus 0.63; P ‫؍‬ 0.04). Reduced CF is associated with physical inactivity, MS, and atherosclerotic burden in glucose-intolerant RTR. Further studies should address whether increasing exercise and modifying MS risk factors improve CF in RTR.

show abstract

“…Oral nutritional supplements (ONS) were offered by 399 facilities; however, this answer included multiple answers so the proportion of each component was assessed among 523 answers ET was enforced in about 20% of the facilities, and only 3% of all the patients were receiving ET. Patients on dialysis have extremely limited exercise capacity and poor physical functioning [28]. It has been reported that sedentary behavior in patients on hemodialysis is associated with an increased risk of death within 1 year even after adjusting for all covariates [29].…”

Section: Discussionmentioning

confidence: 99%

Questionnaire survey on nutritional supplement therapy and exercise training at hemodialysis facilities in Japan

et al. 2017

View full text Add to dashboard Cite

Background: Nutritional therapy and exercise training (ET) are important interventions for hemodialysis patients. We investigated the status of nutritional therapy and ET provided at hemodialysis facilities across Japan. Method: This was a cross-sectional study. The facilities investigated were 3993 facility member institutions of the Japanese Society for Dialysis Therapy in August 2015. Data was collected on the facility type, number of staff (doctors, nurses, and medic al engineers), presence of staff (clinical dietitians, pharmacists, and physical therapists), proportion of elderly patients (age ≥ 65 years), patients with albumin ≤ 3.5 g/dL, and types of oral nutritional supplements (ONS), intradialytic parenteral nutrition (IDPN), and ET in the facility. We summarized data on facilities and patient characteristics and calculated the proportion of the nutrition that were ONS, IDPN, and exercise interventions provided. We used multiple logistic analyses to examine the facility characteristics associated with the provision of nutritional support and ET. Results: We obtained responses from 1048 facilities (response rate 26.2%) and 88,492 patients (27.6%). Patients aged ≥ 65 years accounted for 63.4% of all investigated patients. Patients with Alb ≤ 3.5 g/dL accounted for 37.6% of all investigated patients. Meals during hemodialysis sessions were provided at 601 facilities (64%), ONS were used at 382 facilities (40%), and IDPN was administered at 471 facilities (46%). Exercise during hemodialysis sessions was provided at 190 facilities (20%). These trends did not change after adjustment of response rates by affiliations of facility type and region. At the patient level, only a limited number of patients were provided with ONS, IDPN, and ET, 2.1, 2.7, and 3.0%, respectively. ONS and IDPN were less likely to be offered in hospitals than in clinics without beds (odds ratio (OR) 0.21; 95% confidence interval (CI) 0.09-0.45) (OR 0.37; 95% CI 0.17-0.82). ET was also less likely to be offered in hospitals (OR 0.20; 95% CI 0.08-0.49). Conclusions: Nutritional support therapy is provided in a considerable number of hemodialysis facilities, ET is increasing but offered by fewer facilities compared to other countries, while a limited number of patients were provided with ET.

show abstract

Physical Functioning and Exercise Capacity in Patient on Dialysis

Cited by 122 publications

References 35 publications

Association of Initial Hemodialysis Vascular Access with Patient-Reported Health Status and Quality of Life

Association of Initial Hemodialysis Vascular Access with Patient-Reported Health Status and Quality of Life

Cardiorespiratory Fitness Is Related to Physical Inactivity, Metabolic Risk Factors, and Atherosclerotic Burden in Glucose-Intolerant Renal Transplant Recipients

Questionnaire survey on nutritional supplement therapy and exercise training at hemodialysis facilities in Japan

Contact Info

Product

Resources

About