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Physical activity and its trajectory over time and clinical outcomes in hemodialysis patients

  • Nephrology - Original Paper
  • Published:
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Abstract

Purpose

We examined whether physical activity measured at starting point and its trajectory over time were simultaneously associated with vital prognosis.

Methods

This retrospective cohort study included 295 ambulatory maintenance hemodialysis patients (mean age 63.9 years; 54.6% male). We measured physical activity at index date (starting point) and its change over 1 year as predictors, and all-cause death and cardiovascular events were assessed as the outcomes. Two groups each of high versus low physical activity at starting point (based on 4000 steps per day) and no decline versus decline (based on a predicted mean slope) were created. Cox proportional-hazards regression and Fine–Gray proportional sub-distribution hazards model were used to examine associations between physical activity and its trajectory and clinical outcomes.

Results

Decline in physical activity over 1 year was associated with a higher risk of all-cause death and cardiovascular events, irrespective of the physical activity at starting point. Furthermore, both lower physical activity at starting point and decrease in physical activity over time were independently associated with a higher risk of all-cause death and cardiovascular events in models in which each exposure was mutually adjusted. Compared to other groups that worsened in either exposure, the lowest risk for death/cardiovascular events was observed in the high at starting point/no decline over time group.

Conclusions

Both physical activity at starting point and its change over time were independently associated with vital prognosis. The assessment of both exposures provides additional prognostic information for the assessment of each exposure.

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Data availability

The data underlying this article cannot be shared publicly due to the privacy of individuals that participated in the study. The data will be shared upon reasonable request to the corresponding author.

Code availability

The data will be shared upon reasonable request to the corresponding author.

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Funding

This work was supported by the Japan Society for the Promotion of Science KAKENHI [Grant number: 26350631] with no restriction on publication.

Author information

Authors and Affiliations

  1. Department of Rehabilitation Science, Kitasato University Graduate School of Medical Sciences, 1-15-1 Kitasato, Minami-ku, Sagamihara, Kanagawa, 252-0373, Japan

    Yuta Suzuki, Shohei Yamamoto, Keigo Imamura & Atsuhiko Matsunaga

  2. Department of Rehabilitation, Sagami Circulatory Organ Clinic, Kanagawa, Japan

    Yuta Suzuki & Manae Harada

  3. Advanced Research Course, National Institute of Public Health, Saitama, Japan

    Yuta Suzuki

  4. Department of Physical Therapy, School of Rehabilitation, Hyogo University of Health Sciences, Hyogo, Japan

    Ryota Matsuzawa

  5. Center for Public Health Informatics, National Institute of Public Health, Saitama, Japan

    Keika Hoshi

  6. Department of Hygiene, Kitasato University School of Medicine, Kanagawa, Japan

    Keika Hoshi

  7. LightStone Corp, Tokyo, Japan

    Yong Mo Koh

  8. Department of Economics, School of Economic, Senshu University, Tokyo, Japan

    Yong Mo Koh

  9. Department of Epidemiology and Prevention, Center for Clinical Sciences, National Center for Global Health and Medicine, Tokyo, Japan

    Shohei Yamamoto

  10. Department of Rehabilitation, School of Allied Health Sciences, Kitasato University, Kanagawa, Japan

    Kentaro Kamiya

Authors
  1. Yuta Suzuki
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  2. Ryota Matsuzawa
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  3. Keika Hoshi
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  4. Yong Mo Koh
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  5. Manae Harada
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  6. Shohei Yamamoto
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  7. Keigo Imamura
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  8. Kentaro Kamiya
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  9. Atsuhiko Matsunaga
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Contributions

YS, RM, KH, and AM designed the study. YS, RM, MH, SY, KI, KK, and AM collected the data. YS, RM, KH, YK, and AM analyzed the data. YS, RM, KH, YK, and AM wrote the manuscript. All authors revised the manuscript.

Corresponding author

Correspondence to Atsuhiko Matsunaga.

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Conflict of interest

The authors have no relevant financial or non-financial interests to disclose.

Ethics approval

All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki Declaration and its later amendments or comparable ethical standards. The study was approved by the Institutional Review Board/Ethics Committee of the Kitasato University Allied Health Sciences.

Consent to participate

Informed consent was obtained from all individual participants included in the study.

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Not applicable.

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Suzuki, Y., Matsuzawa, R., Hoshi, K. et al. Physical activity and its trajectory over time and clinical outcomes in hemodialysis patients. Int Urol Nephrol 54, 2065–2074 (2022). https://doi.org/10.1007/s11255-021-03098-w

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  • DOI: https://doi.org/10.1007/s11255-021-03098-w

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