Self-Reported Physical Activity and Survival in Adults Treated With Hemodialysis : A DIET-HD Cohort Study
(2021) In Kidney International Reports 6(12). p.3014-3025- Abstract
Introduction: Regular physical activity is associated with longevity in adults receiving hemodialysis, but it is uncertain whether this association varies by causal pathways (cardiovascular and noncardiovascular). Methods: DIET-HD was a prospective, multinational study of adults undergoing hemodialysis across Europe and Argentina. We classified participants as physically inactive, occasionally active (irregularly to once a week), or frequently active (twice a week or more), using a self-reported questionnaire. Potential confounders were balanced across exposure groups using propensity scores. Weighted Cox proportional hazards models with double robust estimators evaluated the association between physical activity and all-cause,... (More)
Introduction: Regular physical activity is associated with longevity in adults receiving hemodialysis, but it is uncertain whether this association varies by causal pathways (cardiovascular and noncardiovascular). Methods: DIET-HD was a prospective, multinational study of adults undergoing hemodialysis across Europe and Argentina. We classified participants as physically inactive, occasionally active (irregularly to once a week), or frequently active (twice a week or more), using a self-reported questionnaire. Potential confounders were balanced across exposure groups using propensity scores. Weighted Cox proportional hazards models with double robust estimators evaluated the association between physical activity and all-cause, cardiovascular, and noncardiovascular mortality. Results: Of 8043 participants in DIET-HD, 6147 (76%) had information on physical activity. A total of 2940 (48%) were physically inactive, 1981 (32%) occasionally active, and 1226 (20%) frequently active. In a median follow-up of 3.8 years (19,677 person-years), 2337 (38%) deaths occurred, including 1050 (45%) from cardiovascular causes. After propensity score weighting, occasional physical activity was associated with lower all-cause (adjusted hazard ratio [aHR] = 0.80, 95% CI = 0.72–0.89), cardiovascular (aHR = 0.82, 95% CI = 0.70–0.96), and noncardiovascular (aHR = 0.81, 95% CI = 0.69–0.94) mortality compared with inactivity. Frequent physical activity was associated with lower all-cause (aHR = 0.82, 95% CI = 0.71–0.95) and cardiovascular (aHR = 0.77, 95% CI = 0.62–0.94) mortality, but not noncardiovascular mortality (aHR = 0.88, 95% CI = 0.72–1.08). A dose-dependent association of physical activity with cardiovascular death was observed (P trend = 0.01). Conclusion: Compared with self-reported physical inactivity, occasional and frequent physical activities were associated, dose dependently, with lower cardiovascular mortality in adults receiving hemodialysis.
(Less)
- author
- organization
- publishing date
- 2021
- type
- Contribution to journal
- publication status
- published
- subject
- keywords
- hemodialysis, mortality, physical activity
- in
- Kidney International Reports
- volume
- 6
- issue
- 12
- pages
- 3014 - 3025
- publisher
- Elsevier
- external identifiers
-
- scopus:85117920397
- pmid:34901570
- ISSN
- 2468-0249
- DOI
- 10.1016/j.ekir.2021.09.002
- language
- English
- LU publication?
- yes
- additional info
- Publisher Copyright: © 2021 International Society of Nephrology
- id
- 0b52d3b0-3a2b-40f1-ae43-8fd28257bd30
- date added to LUP
- 2021-11-24 08:21:20
- date last changed
- 2024-05-04 17:31:14
@article{0b52d3b0-3a2b-40f1-ae43-8fd28257bd30,
abstract = {{<p>Introduction: Regular physical activity is associated with longevity in adults receiving hemodialysis, but it is uncertain whether this association varies by causal pathways (cardiovascular and noncardiovascular). Methods: DIET-HD was a prospective, multinational study of adults undergoing hemodialysis across Europe and Argentina. We classified participants as physically inactive, occasionally active (irregularly to once a week), or frequently active (twice a week or more), using a self-reported questionnaire. Potential confounders were balanced across exposure groups using propensity scores. Weighted Cox proportional hazards models with double robust estimators evaluated the association between physical activity and all-cause, cardiovascular, and noncardiovascular mortality. Results: Of 8043 participants in DIET-HD, 6147 (76%) had information on physical activity. A total of 2940 (48%) were physically inactive, 1981 (32%) occasionally active, and 1226 (20%) frequently active. In a median follow-up of 3.8 years (19,677 person-years), 2337 (38%) deaths occurred, including 1050 (45%) from cardiovascular causes. After propensity score weighting, occasional physical activity was associated with lower all-cause (adjusted hazard ratio [aHR] = 0.80, 95% CI = 0.72–0.89), cardiovascular (aHR = 0.82, 95% CI = 0.70–0.96), and noncardiovascular (aHR = 0.81, 95% CI = 0.69–0.94) mortality compared with inactivity. Frequent physical activity was associated with lower all-cause (aHR = 0.82, 95% CI = 0.71–0.95) and cardiovascular (aHR = 0.77, 95% CI = 0.62–0.94) mortality, but not noncardiovascular mortality (aHR = 0.88, 95% CI = 0.72–1.08). A dose-dependent association of physical activity with cardiovascular death was observed (P trend = 0.01). Conclusion: Compared with self-reported physical inactivity, occasional and frequent physical activities were associated, dose dependently, with lower cardiovascular mortality in adults receiving hemodialysis.</p>}},
author = {{Bernier-Jean, Amelie and Wong, Germaine and Saglimbene, Valeria and Ruospo, Marinella and Palmer, Suetonia C. and Natale, Patrizia and Garcia-Larsen, Vanessa and Johnson, David W. and Tonelli, Marcello and Hegbrant, Jörgen and Craig, Jonathan C. and Teixeira-Pinto, Armando and Strippoli, Giovanni F.M.}},
issn = {{2468-0249}},
keywords = {{hemodialysis; mortality; physical activity}},
language = {{eng}},
number = {{12}},
pages = {{3014--3025}},
publisher = {{Elsevier}},
series = {{Kidney International Reports}},
title = {{Self-Reported Physical Activity and Survival in Adults Treated With Hemodialysis : A DIET-HD Cohort Study}},
url = {{http://dx.doi.org/10.1016/j.ekir.2021.09.002}},
doi = {{10.1016/j.ekir.2021.09.002}},
volume = {{6}},
year = {{2021}},
}