Exercise to Improve Physical Function and Quality of Life in CKD

Jhamb, Manisha; Weiner, Daniel E.

doi:10.2215/cjn.10411014

Cited by 12 publications

(8 citation statements)

References 11 publications

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“…Knowledge about the risk factors for poor HRQoL can guide identification of vulnerable ESRD patients and development of interventions to help them. Certain determinants of HRQoL in ESRD patients, not only clinical factors but also mental factors, are potentially modifiable [23, 55]. Early identification and correction of such factors may potentially lead to improving the overall well-being of patients.…”

Section: Discussionmentioning

confidence: 99%

Health-related quality of life as predictor of mortality in end-stage renal disease patients: an observational study

et al. 2019

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Background Health-related quality of life (HRQoL) is an important component of patient-centered outcomes and a useful parameter for monitoring quality of care. We assessed HRQoL, its determinants, and associations with mortality in patients with end-stage renal disease (ESRD). Methods Short Form-36 was used to assess HRQoL, its domain components, and physical (PCS) and mental (MCS) composite summary scores in altogether 400 (338 incident and 62 prevalent) dialysis patients with median age 64 years, 37% women, 24% diabetes mellitus (DM), 49% cardiovascular disease (CVD), and median estimated glomerular filtration rate (eGFR) of 5.3 (3.0–9.4) ml/min/1.73 2 . Results were analyzed separately for 338 incident patients starting on hemodialysis (HD; 68%) or peritoneal dialysis (PD; 32%), and 62 prevalent PD patients. Mortality risk was analyzed during up to 60 months (median 28 months). Results Linear multivariate regression analysis showed that in incident dialysis patients, 1-SD higher PCS associated negatively with 1-SD higher age, DM and CVD, and positively with 1-SD higher hemoglobin and sodium (adjusted r 2 = 0.17). In 62 prevalent PD patients, 1-SD higher PCS was negatively associated with 1-SD higher age. MCS was not associated to any of the investigated factors. Multivariate Cox regression analysis showed that in incident dialysis patients, 1-SD increase of PCS associated with lower all-cause mortality, hazard ratio 0.65 (95% confidence interval 0.52–0.81), after adjustments for age, sex, DM, CVD, plasma albumin, C-reactive protein and eGFR whereas 1-SD lower MCS did not associate with mortality. In PD patients, neither PCS nor MCS associated with mortality. Conclusions MCS did not associate with any of the investigated clinical factors, whereas lower PCS associated with higher age, CVD, DM, and lower hemoglobin and sodium levels. MCS was not associated with mortality, whereas lower PCS associated with increased mortality risk. These results suggest that HRQoL - in addition to its role as patient-centered outcome - matters also for hard clinical outcomes in ESRD patients. Our knowledge about factors influencing MCS in ESRD patients is limited and should motivate further studies. Electronic supplementary material The online version of this article (10.1186/s12882-019-1318-x) contains supplementary material, which is available to authorized users.

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Section: Discussionmentioning

confidence: 99%

Health-related quality of life as predictor of mortality in end-stage renal disease patients: an observational study

et al. 2019

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“…Sarcopenia and its individual criteria (hand grip strength, slow gait speed) are associated with mortality in hemodialysis patients [26]. Otherwise, intervention by structured exercise programs, which increase muscle mass in these patients, is proven to ameliorate functional parameters, body composition, quality of life, and survival [27][28][29].…”

Section: Obesity In Advanced Ckd and Dialysis: A Paradoxmentioning

confidence: 99%

Preventive Nephrology: The Role of Obesity in Different Stages of Chronic Kidney Disease

Pommer¹

2018

Kidney Dis

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Background: Obesity is increasing worldwide and has become a nontraditional risk factor in chronic kidney disease (CKD). Summary: Obesity-related nephropathy may aggravate renal complications of the metabolic syndrome and progress to advanced CKD stages, while obesity in early stages of CKD is clearly related to the development of kidney disease. A high body mass index (BMI) in advanced CKD stages and dialysis is an advantage for survival (so called “obesity paradox”). A high lean body to fat mass index indicates a beneficial state of body composition. In contrast, loss of muscle mass with increasing fat mass causes “sarcopenia obesity,” which is related to unfavorable outcomes in renal replacement therapy. Obesity (BMI > 30–35) in renal transplant recipients is associated with a higher risk of complications such as delayed graft function, increased rates of rejection, and graft loss. While conservative management of morbid obesity is failing in most cases, bariatric surgery seems to be an option in some cases to improve renal complications in the early stage of CKD or in transplant candidates. Key Message: In conclusion, obesity is increasingly prevalent among CKD patients. Adequate management with respect to the specific role of obesity in different stages of CKD should be integrated in routine renal care.

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“…Contrarily, other studies pointed to survival advantages in advanced CKD that correlates with body weight gain (for review, see [12]). Researchers suggest that the benefits of body weight gain are implicitly related to muscle mass increase, which helps in improving patient's health [13][14][15][16]. Between these two paradoxical facts, we studied the impact of obesity on hemodialysis efficiency of CKD patients, in northern Lebanon.…”

Section: Discussionmentioning

confidence: 99%

Negative Impact of Obesity on Dialysis Efficiency: A Prospective Cohort on Lebanese CKD Patients

Haddad¹

2020

AJBSR

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Exercise to Improve Physical Function and Quality of Life in CKD

Cited by 12 publications

References 11 publications

Health-related quality of life as predictor of mortality in end-stage renal disease patients: an observational study

Health-related quality of life as predictor of mortality in end-stage renal disease patients: an observational study

Preventive Nephrology: The Role of Obesity in Different Stages of Chronic Kidney Disease

Negative Impact of Obesity on Dialysis Efficiency: A Prospective Cohort on Lebanese CKD Patients

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