Accelerometry Correlates in Body Composition, Physical Fitness, and Disease Symptom Burden: A Pilot Study in End-Stage Renal Disease

Abstract

There is strong evidence that hemodialysis (HD) patients with a sedentary lifestyle have a higher risk of death compared to peers who engage in regular physical activity. Therefore, monitoring physical activity is of utmost importance. However, there is a lack of data on objectively measured physical activity behaviors in HD patients. Therefore, this study aimed to objectively measure physical activity in HD patients throughout the week, with particular attention to dialysis and non-dialysis days. We also examined how objectively measured physical activity correlated with physical fitness, body composition, and disease burden. Daily physical activity, body composition, serum parameters, comorbidity index, sit-to-stand, and hand-grip strength tests were measured in 14 HD patients. Daily physical activity was measured using the Actigraph GT9X accelerometer. The Dialysis Symptom Index questionnaire was also used. We found significant differences in anthropometric variables (weight, body mass index, overhydration, lean tissue index, and fat tissue index, all p < 0.05) and phase angle (p < 0.01) between HD patients reaching and patients not reaching physical activity guidelines for patients with chronic diseases. HD patients showed to be less active during dialysis days compared to non-dialysis days as indicated in sedentary time (–11.7%; p = 0.001), light (–47.3%; p = 0.003), moderate (–51.5%; p = 0.001), moderate to vigorous (–49.3%; p = 0.001), and vigorous (–34.3%; p = 0.067) physical activity. No significant correlations were found among serum parameters, symptom burden, and comorbidity burden, but a very large and positive correlation was found between phase angle and total moderate to vigorous physical activity (p < 0.01). Our findings support the need to implement physical activity on dialysis days in HD units to mitigate the effects of sedentary behavior. Prospective, long-term studies evaluating the use of accelerometers in HD patients and their effects on physical activity are needed.

Diffusion tensor imaging of the brain white matter microstructure in patients with chronic kidney disease and its correlation with cognition

“…Beam-based spatial statistics (TBSS) is a more accurate and comprehensive method for assessing the microstructural changes in whole-brain white matter. Because cognitive impairment in different regions can be reflected by neuroimaging abnormalities, it is important to understand the interaction between cognitive impairment and structural brain tissue damage caused by different degrees of renal damage to minimize the risk of neurological injury in CKD patients ( 11 ). In this study, we aimed to investigate the correlation between diffusion parameters obtained from abnormal white matter bundle DTI and cognitive function in CKD patients.…”

Sarcopenia and sarcopenic obesity in chronic kidney disease: update on prevalence, outcomes, risk factors and nutrition treatment

“…A number of factors inherent to CKD contribute to reduced muscle mass and function, ultimately leading to sarcopenia [3]. Lifestyle factors may also contribute to sarcopenia, as patients with CKD show reduced muscle mass and lower exercise tolerance as the disease progresses [38,39,40 ▪ ,41 ▪▪ ]. High total and central body adiposity contribute to sarcopenia through a bi-direction relationship with reduced physical activity and unbalanced diet.…”

“…Reduced physical activity and sarcopenia have a bidirectional relationship. Loss of skeletal muscle mass and strength increased the risk for mobility limitations, physical disability, low quality of life and mortality [38,40 ▪ ]. Among CKD populations, physical activity is low and appears to be worse in haemodialysis compared with NDD-CKD [41 ▪▪ ].…”

The Impact of Intradialytic Cognitive and Physical Training Program on the Physical and Cognitive Abilities in End-Stage Kidney Disease Patients: A Randomized Clinical Controlled Trial

“…In addition, the pilot study on HD patients demonstrated that cognitive training and physical exercise separately prevented cognitive decline [ 29 ]. A growing number of studies on exercise training in the HD population show improvements in quality of life [ 30 , 31 ], body composition [ 32 ], inflammation [ 33 ], dialysis symptoms [ 34 , 35 ], and cognitive function [ 36 , 37 ]. Despite the previously mentioned positive impacts of physical exercise, there is a lack of randomized controlled trials that explore its effects on cognitive performance in HD patients.…”