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. 2021 Jun 18;22(1):227.
doi: 10.1186/s12882-021-02407-w.

Association between physical activity and mortality in end-stage kidney disease: a systematic review of observational studies

Pedro Martins  1   2 , Elisa A Marques  1 , Diogo V Leal  1 , Aníbal Ferreira  2   3   4 , Kenneth R Wilund  5 , João L Viana  6
Affiliations

Association between physical activity and mortality in end-stage kidney disease: a systematic review of observational studies

Pedro Martins et al. BMC Nephrol. .

Abstract

Background: End-stage Kidney Disease patients have a high mortality and hospitalization risk. The association of these outcomes with physical activity is described in the general population and in other chronic diseases. However, few studies examining this association have been completed in end-stage Kidney Disease patients, raising the need to systematically review the evidence on the association of physical activity with mortality and hospitalization in this population.

Methods: Electronic databases (EBSCO, Scopus and Web of Science) and hand search were performed until March 2020 for observational studies reporting the association of physical activity with mortality or hospitalization in adult end-stage Kidney Disease patients on renal replacement therapy (hemodialysis, peritoneal dialysis and kidney transplant). Methodological quality of the included studies was assessed using the Quality in Prognosis Studies tool. The review protocol was registered in PROSPERO (CRD42020155591).

Results: Eleven studies were included: six in hemodialysis, three in kidney transplant, and two in hemodialysis and peritoneal dialysis patients. Physical activity was self-reported, except in one study that used accelerometers. All-cause mortality was addressed in all studies and cardiovascular mortality in three studies. Nine studies reported a significant reduction in all-cause mortality with increased levels of physical activity. Evidence of a dose-response relationship was found. For cardiovascular mortality, a significant reduction was observed in two of the three studies. Only one study investigated the association of physical activity with hospitalization.

Conclusions: Higher physical activity was associated with reduced mortality in end-stage Kidney Disease patients. Future studies using objective physical activity measures could strengthen these findings. The association of physical activity with hospitalization should be explored in future investigations.

Keywords: Chronic Kidney Disease; Hemodialysis; Hospitalization; Physical Activity; Survival.

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Conflict of interest statement

The authors declare that they have no competing interests.

Figures

Fig. 1
Fig. 1
Flowchart of studies selection. PA physical activity; CKD chronic kidney disease
Fig. 2
Fig. 2
Results of the included studies comparing all-cause mortality in most active and inactive groups
See this image and copyright information in PMC

References

    1. Ortiz A, Covic A, Fliser D, Fouque D, Goldsmith D, Kanbay M, et al. Epidemiology, contributors to, and clinical trials of mortality risk in chronic kidney failure. Lancet. 2014;383(9931):1831–43. - PubMed
    1. Klarenbach SW, Tonelli M, Chui B, Manns BJ. Economic evaluation of dialysis therapies. Nat Rev Nephrol. 2014;10(11):644–52. doi: 10.1038/nrneph.2014.145. - DOI - PubMed
    1. United States Renal Data System. Epidemiology of kidney disease in the United States. National Institutes of Health, National Institute of Diabetes and Digestive and Kidney Diseases, Bethesda, MD, 2018. Available at https://www.usrds.org/2018/view/Default.aspx.
    1. SONG Initiative. The SONG Handbook. Version 1.0 June 2017, Sydney, Australia Available at songinitiative.org/reports-and-publications/.
    1. Manera KE, Tong A, Craig JC, Shen J, Jesudason S, Cho Y, et al. An international Delphi survey helped develop consensus-based core outcome domains for trials in peritoneal dialysis. Kidney Int. 2019;96(3):699–710. doi: 10.1016/j.kint.2019.03.015. - DOI - PMC - PubMed

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