Department of Rehabilitation Sciences, Graduate School of Medical Sciences, Kitasato University, Sagamihara, Japan.
Clin J Am Soc Nephrol. 2012 Dec;7(12):2010-6. doi: 10.2215/CJN.03660412. Epub 2012 Sep 13.
The association between mortality and physical activity based on self-report questionnaire in hemodialysis patients has been reported previously. However, because self-report is a subjective assessment, evaluating true physical activity is difficult. This study investigated the prognostic significance of habitual physical activity on 7-year survival in a cohort of clinically stable and adequately dialyzed patients.
DESIGN, SETTING, PARTICIPANTS, & MEASUREMENTS: A total of 202 Japanese outpatients who were undergoing maintenance hemodialysis three times per week at the hemodialysis center of Sagami Junkanki Clinic (Japan) from October 2002 to February 2012 were followed for up to 7 years. Physical activity was evaluated using an accelerometer at study entry and is expressed as the amount of time a patient engaged in physical activity on nondialysis days. Cox proportional hazard regression was used to assess the contribution of habitual physical activity to all-cause mortality.
The median patient age was 64 (25th, 75th percentiles, 57, 72) years, 52.0% of the patients were women, and the median time on hemodialysis was 40.0 (25th, 75th percentiles, 16.8, 119.3) months at baseline. During a median follow-up of 45 months, 34 patients died. On multivariable analysis, the hazard ratio for all-cause mortality per 10 min/d increase in physical activity was 0.78 (95% confidence interval, 0.66-0.92; P=0.002).
Engaging in habitual physical activity among outpatients undergoing maintenance hemodialysis was associated with decreased mortality risk.
先前有研究报告称，基于自我报告问卷的血液透析患者的死亡率与身体活动之间存在关联。然而，由于自我报告是一种主观评估，因此评估真实的身体活动较为困难。本研究旨在调查队列中临床稳定且充分透析的患者习惯性身体活动对 7 年生存率的预后意义。
设计、地点、参与者和测量：共有 202 名日本门诊患者参加了此项研究，他们于 2002 年 10 月至 2012 年 2 月在日本相模 Junkanki 诊所的血液透析中心每周接受 3 次维持性血液透析。研究开始时使用加速度计评估身体活动量，并用患者在非透析日进行身体活动的时间来表示。使用 Cox 比例风险回归来评估习惯性身体活动对全因死亡率的贡献。
患者的中位年龄为 64（25 分位，75 分位，57，72）岁，52.0%的患者为女性，基线时血液透析的中位时间为 40.0（25 分位，75 分位，16.8，119.3）个月。在中位随访 45 个月期间，有 34 名患者死亡。多变量分析显示，身体活动每增加 10 分钟/天，全因死亡率的风险比为 0.78（95%置信区间，0.66-0.92；P=0.002）。
接受维持性血液透析的门诊患者习惯性地进行身体活动与降低死亡率风险相关。
