Clinical and Experimental Medicine, University of Pisa, Pisa, Italy.
Department of Statistics, Computer Science, Applications "G. Parenti," University of Florence, Florence, Italy.
Kidney Blood Press Res. 2024;49(1):978-986. doi: 10.1159/000541902. Epub 2024 Oct 21.
Nutrition and physical activity are two major issues in the management of CKD patients who are often older, have comorbidities, and are prone to malnutrition and physical inactivity, conditions that cause loss of quality of life and increase the risk of death. We performed a multidimensional assessment of nutritional status and of physical performance and activity in CKD patients on conservative therapy in order to assess the prevalence of sedentary behavior and its relationship with body composition.
A total of 115 consecutive stable CKD patients aged 45-80 years were included in the study. They had no major skeletal, muscular, or neurological disabilities. All patients underwent a multidimensional assessment of body composition, physical activity, and exercise capacity.
Sedentary patients, as defined by mean daily METs <1.5, were older and differed from non-sedentary patients in terms of body composition, exercise capacity, and nutrient intake, even after adjusting for age. Average daily METs were positively associated with lean body mass, muscle strength, 6MWT performance but negatively associated with fat body mass, body mass index, and waist circumference. In addition, a sedentary lifestyle may have negative effects on free fat mass, muscle strength, and exercise capacity and may increase fat body mass. Conversely, decrease in muscle mass and/or an increase in fat mass may lead to a decrease in physical activity and exercise capacity.
There is a clear association and potential interrelationship between nutritional aspects and exercise capacity in older adults with CKD: they are really the two sides of the same coin.
营养和身体活动是慢性肾脏病（CKD）患者管理中的两个主要问题，这些患者通常年龄较大，合并症较多，容易出现营养不良和身体活动不足，这些情况会导致生活质量下降，并增加死亡风险。我们对接受保守治疗的 CKD 患者进行了营养状况和身体活动能力的多维评估，以评估久坐行为的流行情况及其与身体成分的关系。
共纳入 115 例年龄 45-80 岁的连续稳定 CKD 患者，无主要骨骼、肌肉或神经功能障碍。所有患者均接受了身体成分、身体活动和运动能力的多维评估。
以平均每日代谢当量（METs）<1.5 定义为久坐患者，这些患者比非久坐患者年龄更大，且在身体成分、运动能力和营养摄入方面存在差异，即使在调整年龄后也是如此。平均每日 METs 与瘦体重、肌肉力量、6 分钟步行试验（6MWT）表现呈正相关，而与体脂量、体重指数和腰围呈负相关。此外，久坐的生活方式可能对游离脂肪量、肌肉力量和运动能力产生负面影响，并可能增加体脂量。相反，肌肉质量的减少和/或脂肪质量的增加可能导致身体活动和运动能力的下降。
在患有 CKD 的老年人中，营养状况和运动能力之间存在明显的关联和潜在的相互关系：它们实际上是同一枚硬币的两面。
