Prevalence and correlates of physical activity across kidney disease stages: an observational multicentre study

Abstract

Background People with chronic kidney disease (CKD) report high levels of physical inactivity, a major modifiable risk factor for morbidity and mortality. Understanding the biological, psychosocial and demographic causes of physical activity behaviour is essential for the development and improvement of potential health interventions and promotional initiatives. This study investigated the prevalence of physical inactivity and determined individual correlates of this behaviour in a large sample of patients across the spectrum of kidney disease. Methods A total of 5656 people across all stages of CKD (1–2, 3, 4–5, haemodialysis, peritoneal dialysis and renal transplant recipients) were recruited from 17 sites in England from July 2012 to October 2018. Physical activity was evaluated using the General Practice Physical Activity Questionnaire. Self-reported cardiorespiratory fitness, self-efficacy and stage of change were also assessed. Binominal generalized linear mutually adjusted models were conducted to explore the associations between physical activity and correlate variables. This cross-sectional observational multi-centre study was registered retrospectively as ISRCTN87066351 (October 2015). Results The prevalence of physical activity (6–34%) was low and worsened with disease progression. Being older, female and having a greater number of comorbidities were associated with greater odds of being physically inactive. Higher haemoglobin, cardiorespiratory fitness and self-efficacy levels were associated with increased odds of being active. Neither ethnicity nor smoking history had any effect on physical activity. Conclusions Levels of physical inactivity are high across all stages of CKD. The identification of stage-specific correlates of physical activity may help to prioritize factors in target groups of kidney patients and improve the development and improvement of public health interventions.

Factors affecting exercise self-efficacy in non-dialysis patients with chronic kidney disease: a cross-sectional study

“…From the stage of disease perspective, this study also found that the patients' exercise self-e cacy gradually decreased as the progress of the renal function. A similar result was found by Wilkinson et al, whose study used the General Practice Physical Activity Questionnaire to evaluate CKD patients' physical activity, the result showed that 34% patients in CKD stage 1-2 were su ciently active, but decreased from stage 3 (17% active), through to stage 4-5 (11% active), and reaching a nadir in patients received dialysis (only 6%-8%) [20]. It is perhaps unsurprising that physical activity levels worsen as CKD progresses given the increasing symptom burden and reductions in physical function aggravated by anemia, metabolic acidosis, in ammation, and malnutrition [23].…”

“…Epidemiological investigations have shown that the level of physical activity in the population decreases with age [18], we found the score of ESES in elderly patients (≥ 65 years) was lower than that of nonelderly patients (< 65 years) probably because the muscle strength, muscle endurance, and motivation of elderly patients are worse than those of non-elderly patients, besides, decreased renal function exacerbates these factors [19]. Recently, a large cross-sectional study from the United Kingdom, nondialysis patients with CKD among males were approximately three times more likely to engage in physical activity than females [20]. Similar results were observed in the present study, which showed that the male in the study scored higher than female.…”

Intradialytic exercise in the treatment of social frailty: a single-center prospective study—preliminary results during the unexpected COVID-19 pandemic

“…Our result can be explained by the fact that hemodialysis patients are prone to have sedentary lifestyles and to have low levels of physical activity [5,6]. Other studies also reported that decreased physical activity was associated with reduced walking speed in hemodialysis patients [7,8].…”

Intradialytic exercise in the treatment of social frailty during the COVID-19 pandemic: A single-center prospective study

“…Our result can be explained by the fact that hemodialysis patients are prone to have sedentary lifestyles and to have low levels of physical activity. 7,8 Other studies also reported that decreased physical activity was associated with reduced walking speed in hemodialysis patients. 9,10 We can speculate that social frailty such as a reduced frequency of going out and social visits with friends, reduces walking speed by limiting patients' opportunities to engage in physical activity.…”