Physical function and physical activity in hemodialysis patients with peripheral artery disease

Abstract

Introduction: Peripheral artery disease (PAD) is commonly observed in patients undergoing hemodialysis. PAD impairs the vasculature and leads to pathophysiologic changes in the skeletal muscles, causing physical function impairment and physical inactivity in general. However, it is unclear whether PAD adversely affects physical function and physical activity in patients on hemodialysis.Methods: We performed a cross-sectional study with a retrospective review of the data to determine whether PAD is associated with impaired physical function and physical activity in patients undergoing hemodialysis. The study population comprised 310 patients and 88 healthy subjects. PAD was diagnosed based on an ankle-brachial index of <1.00 in patients on hemodialysis. Measurements of physical function included maximum walking speed, muscle strength in the lower extremities, and balance while standing.Findings: Of the 310 patients, 84 (27.1%) had PAD. When patients undergoing hemodialysis were divided into those without PAD and those with PAD, both groups had poorer physical function and physical activity than the healthy control subjects. After adjustments for potential confounders, it was found that patients on hemodialysis with PAD had slower walking speed, poorer standing balance, and less physical activity than those without PAD. However, there was no significant difference in lower extremity muscle strength between the two groups. Discussion: PAD diagnosed based on an ankle-brachial index of <1.00 was independently associated with impaired physical function and reduced physical activity in patients undergoing hemodialysis.

Prosthesis use and the change in activities of daily living following below‐knee amputation in patients undergoing hemodialysis

“…Patients with renal failure treated with hemodialysis have a high prevalence of peripheral artery disease, [10][11][12][13] and they are at a higher risk of amputation due to ischemic limbs as compared with non-renal populations. [14][15][16] So far, however, no previous studies have examined the benefit of prosthesis use in activities of daily living among hemodialysis patients who underwent major amputation.…”

Home-Based Exercise in Elderly Patients with Claudication and Chronic Kidney Disease Is Associated with Lower Progressive Renal Function Worsening: A 5-Year Retrospective Study

“…Patients with PAD-CKD are exposed to higher cardiovascular risk [ 8 ], to the onset of a more severe stage of PAD, such as chronic limb ischemia [ 10 ], and to worse surgical outcomes, such as a higher rate of reinterventions and amputations [ 11 ], which are strongly associated with albuminuria [ 7 ]. Moreover, in patients undergoing hemodialysis, PAD is associated with impaired physical function and reduced physical activity [ 12 ].…”