Physical activity levels in patients on hemodialysis and healthy sedentary controls

被引:368
作者
Johansen, KL
Chertow, GM
Ng, AV
Mulligan, K
Carey, S
Schoenfeld, PY
Kent-Braun, JA
机构
[1] Univ Calif San Francisco, Moffitt Long Hosp, San Francisco VA Med Ctr, Div Nephrol, San Francisco, CA USA
[2] Univ Calif San Francisco, UCSF Mt Zion Med Ctr, San Francisco, CA USA
[3] Univ Calif San Francisco, San Francisco Gen Hosp, Dept Med, San Francisco, CA USA
[4] Univ Calif San Francisco, San Francisco Gen Hosp, Dept Radiol, San Francisco, CA USA
[5] Univ Calif San Francisco, San Francisco Gen Hosp, Dept Physiol Nursing, San Francisco, CA USA
关键词
end-stage renal disease; exercise; mortality and physical inactivity; dialysis; nutrition; uremic muscle;
D O I
10.1046/j.1523-1755.2000.00116.x
中图分类号
R5 [内科学]; R69 [泌尿科学(泌尿生殖系疾病)];
学科分类号
1002 ; 100201 ;
摘要
Background. Patients on dialysis have reduced exercise tolerance compared with age-matched sedentary controls. The reasons for this debility have not been fully elucidated, but physical inactivity could be a contributing factor. The purpose of the current study was to determine whether patients on hemodialysis are less active than healthy sedentary controls and to explore clinical correlates of physical activity level in a group of hemodialysis patients. Methods. Thirty-four hemodialysis patients and 80 healthy sedentary individuals participated in the study. Physical activity was measured for seven days with a three-dimensional accelerometer and with an activity questionnaire. Results. Vector magnitude values from the accelerometer for the dialysis and control subjects were 104,718 +/- 9631 and 161,255 +/- 6792 arbitrary units per day, respectively (P < 0.0001, mean +/- SEM). The estimated energy expenditure values derived from the questionnaire were 33.6 +/- 0.5 kcal/kg/day and 36.2 +/- 0.5 kcal/kg/day (P = 0.002). The difference between patients on dialysis and controls increased with advancing age. Among the dialysis subjects, some measures of nutritional status correlated with physical activity level, including serum albumin concentration (r = 0.58, P = 0.003), serum creatinine concentration (r = 0.37, P = 0.03), and phase angle derived from bioelectrical impedance analysis (r = 0.40, P = 0.02). Conclusions. Patients on hemodialysis are less active than healthy sedentary controls, and this difference is more pronounced among older individuals. There is an association between the level of physical activity and nutritional status among patients on dialysis. These findings are of great concern, given the trend toward increasing age in incident dialysis patients and the well-known association between inactivity and increased mortality in the general population.
引用
收藏
页码:2564 / 2570
页数:7
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