Associations of self-reported physical activity types and levels with quality of life, depression symptoms, and mortality in hemodialysis patients: the DOPPS
Antonio Alberto Lopes, Brett Lantz, Hal Morgenstern, Mia Wang, Brian A Bieber, Brenda W Gillespie, Yun Li, Patricia Painter, Stefan H Jacobson, Hugh C Rayner, Donna L Mapes, Raymond C Vanholder, Takeshi Hasegawa, Bruce M Robinson, Ronald L Pisoni, Antonio Alberto Lopes, Brett Lantz, Hal Morgenstern, Mia Wang, Brian A Bieber, Brenda W Gillespie, Yun Li, Patricia Painter, Stefan H Jacobson, Hugh C Rayner, Donna L Mapes, Raymond C Vanholder, Takeshi Hasegawa, Bruce M Robinson, Ronald L Pisoni
Abstract
Background and objectives: Physical activity has been associated with better health status in diverse populations, but the association in patients on maintenance hemodialysis is less established. Patient-reported physical activities and associations with mortality, health-related quality of life, and depression symptoms in patients on maintenance hemodialysis in 12 countries were examined.
Design, setting, participants, & measurements: In total, 5763 patients enrolled in phase 4 of the Dialysis Outcomes and Practice Patterns Study (2009-2011) were classified into five aerobic physical activity categories (never/rarely active to very active) and by muscle strength/flexibility activity using the Rapid Assessment of Physical Activity questionnaire. The Kidney Disease Quality of Life scale was used for health-related quality of life. The Center for Epidemiologic Studies Depression scale was used for depression symptoms. Linear regression was used for associations of physical activity with health-related quality of life and depression symptoms scores. Cox regression was used for association of physical activity with mortality.
Results: The median (interquartile range) of follow-up was 1.6 (0.9-2.5) years; 29% of patients were classified as never/rarely active, 20% of patients were classified as very active, and 20.5% of patients reported strength/flexibility activities. Percentages of very active patients were greater in clinics offering exercise programs. Aerobic activity, but not strength/flexibility activity, was associated positively with health-related quality of life and inversely with depression symptoms and mortality (adjusted hazard ratio of death for very active versus never/rarely active, 0.60; 95% confidence interval, 0.47 to 0.77). Similar associations with aerobic activity were observed in strata of age, sex, time on dialysis, and diabetes status.
Conclusions: The findings are consistent with the health benefits of aerobic physical activity for patients on maintenance hemodialysis. Greater physical activity was observed in facilities providing exercise programs, suggesting a possible opportunity for improving patient outcomes.
Keywords: depression; hemodialysis; mortality; outcomes.
Copyright © 2014 by the American Society of Nephrology.
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Source: PubMed