Physical function, regardless of how it is measured, is strikingly low in patients at all stages of CKD. Patients with CKD have slow gait speed, recently demonstrated to be a strong predictor of mortality in CKD patients of all ages. In a recent study, researchers have reported that higher levels of physical activity were associated with about 50% lower all-cause mortality in the advanced CKD population. The study findings were published in the American Journal of Kidney Diseases on February 10, 2021.
In the general population, lower physical activity is associated with poorer quality of life and greater all-cause mortality. However, the association of lower activity and outcomes in advanced CKD patients remain unclear. Therefore, researchers of Canada conducted a study to assess if lower physical activity levels are associated with adverse health outcomes in patients with advanced CKD.
It was a multi-centre prospective cohort study of 579 adult patients with CKD Stages G4-G5 treated at four Canadian multidisciplinary kidney health clinics between 2012 and 2018. The major outcomes assessed were all-cause mortality, progression to kidney failure, and future falls. Researchers analyzed the outcomes using time-dependent proportional hazards models and logistic regression models. Patients were followed for 1,193 days, during which 118 patients died, 204 progressed to dialysis and 129 reported a fall.
Researchers noted that compared to low physical activity, higher levels of physical activity were associated with a 52% lower all-cause mortality (adjusted HR 0.48) in models adjusted for age, sex, and comorbidity. However, they observed no association between higher levels of physical activity and either a slower progression to kidney failure or a lower rate of future falls.
The authors concluded, "Higher levels of physical activity were associated with about 50% lower all-cause mortality in the advanced CKD population. These findings are consistent with a potential benefit from maintained physical activity as patients approach kidney failure."
For further information:
https://www.ajkd.org/article/S0272-6386(21)00082-2/fulltext