DIALYSIS GENERAL
Makaleler > Tam Makale · 2014
Yazarlar: M. Panaye, A. Kolko-Labadens, C. Lasseur, J. L. Paillasseur, M. P. Guillodo, M. Levannier, D. Teta, D. Fouque, S. N. Van Der Veer, M. W. Van De Luijtgaarden, E. A. Brown, K. J. Jager, W. Van Biesen, B. Canaud, I. Bayh, D. Marcelli, P. Ponce, J. I. Merello, K. Gurevich, E. Ladanyi, E. Ok, A. Grassmann, L. Scatizzi, E. Gatti, D. Lofaro, J. L. Vogelzang, K. J. Van Stralen, K. J. Jager, J. W. Groothoff, L. Huber, S. Saith, M. Kheda, S. Baer, N. Nahman, R. Colombo, K. Kintziger
Nephrology Dialysis Transplantation, Uluslararası, Wos, 2014, cilt 29, ss iii32-iii33
DOI: 10.1093/ndt/gfu122
Özet
Introduction and Aims: Physical inactivity is a risk factor for mortality in dialysis patients and is still poorly documented during maintenance dialysis (MD). The Step by Step initiative aimed at evaluating the weekly physical activity on a large cohort of dialysis patients.Methods: All French nephrologists were invited to participate in this national prospective multicenter observational study.149 investigators included 1163 adult patients who were on MD since more than 3 months.Physical activity was assessed by the number of daily steps measured by a pedometer (model NO PE317C multifunction pedometer, USA) for 7 consecutive days .Results: Median age was 63 yr (Q1 51-Q3 75), 66% were male.Most patients (95%) were on HD (median 3yr).24% were diabetic, 69% had hypertension, and 22% had peripheral arterial disease.63% were sedentary (< 5000 steps/d) with a median of 3688 steps /d.Self assessment of physical activity did not allow a proper evaluation with overestimation.Daily steps were lower on dialysis days (DD) (2912, 1439-5232) compared to non DD (4054, 2136-7108) ( p <0.001).Physical activity decreased with age with 57% being sedentary between 50 and 65 yr and above up to 83% after 80 yr.Beyond this age effect, we identified for the first time, with an innovative statistical analysis, specific phenotypes of patients with lower physical activity, such as inflammation, cardio-vascular disease, protein energy wasting, obesity and diabetes.By contrast, previous kidney transplantation and a higher muscular mass were associated with higher physical activity.Conclusions: This survey, largest ever done, highlights the low level of physical activity in MD patients.Patients are mostly sedentary despite being younger than average with a number of daily steps less than 5000.Regular and objective evaluation of physical activity, using a pedometer seems warranted in the dialysis population.These results confirm the need to enforce rehabilitation programs and to act on patient's modifiable phenotypes to ameliorate morbidity, mortality and quality of life.