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. 2017 Aug 23;12(8):e0183642.
doi: 10.1371/journal.pone.0183642. eCollection 2017.

Association of physical activity with cardiovascular and renal outcomes and quality of life in chronic kidney disease

Yi-Chun Tsai  1   2 , Hui-Mei Chen  3   4 , Shih-Ming Hsiao  5 , Cheng-Sheng Chen  3   6 , Ming-Yen Lin  2   7 , Yi-Wen Chiu  2   7 , Shang-Jyh Hwang  2   7 , Mei-Chuan Kuo  2   7
Affiliations

Association of physical activity with cardiovascular and renal outcomes and quality of life in chronic kidney disease

Yi-Chun Tsai et al. PLoS One. .

Abstract

Patients with chronic kidney disease (CKD) are more readily prone to have impaired physical activity than the general population. The aim of this study is to examine the relationship between physical activity and adverse clinical outcomes and quality of life (QOL) in CKD. One hundred and sixty-one patients with CKD stages 1-5 was enrolled from February 2013 to September 2013 and followed up until June 2016. Physical activity was measured using high handgrip strength, 30-second chair stand, and 2-minute step. The QOL was assessed using the Taiwan version of the World Health Organization Quality of Life-BREF. Clinical outcomes included commencing dialysis, major adverse cardiovascular events (MACEs), and first hospitalization. Of all participants, 1 kgf increase in handgrip strength was significantly associated with 0.13 score increase in total scores of QOL and 0.05 score increase in physical domain of QOL in adjusted analysis. One time increase in 30-second chair stand was significantly correlated with 0.14 score increase in psychological domain of QOL. Over a mean follow-up period of 29.1±11.2 months, 37 (23.0%) reached commencing dialysis, 11(6.8%) had MACEs, and 50(31.1%) had first hospitalization. High handgrip strength (hazard ratio (HR): 0.89, 95% CI: 0.84-0.96) and high 2-minute step (HR: 0.04, 95% CI: 0.01-0.95) were significantly associated with decreased risk for commencing dialysis in multivariate analysis. Thirty-second chair-stand was negatively associated with MACEs (HR: 0.65, 95%CI: 0.47-0.89) and first hospitalization (HR: 0.84, 95%CI: 0.74-0.95). In conclusion, physical activity is a potential predictor of QOL and adverse clinical outcomes in patients with CKD.

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Conflict of interest statement

Competing Interests: The authors have declared that no competing interests exist.

Figures

Fig 1
Fig 1
The cumulative probability of (A) commencing dialysis (B) major adverse cardiovascular events (MACE) (C) first hospitalization according to physical activity. The median of 2-minute step, handgrip strength, and 30-second chair stand was 105, 26.4kgf, and 11 respectively.
Fig 2
Fig 2. Adjusted hazard ratios (HRs) of commencing dialysis for handgrip strength in all chronic kidney disease patients stratified by age, sex, and serum albumin level.
Ratios were adjusted for age, sex, creatinine. The median of serum albumin was 4.2 g/dl. 95% CI, 95% confidence intervals.
See this image and copyright information in PMC

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