Practice pattern of physician’s directions of exercise restriction in patients with chronic kidney disease: results from the Chronic Kidney Disease Japan Cohort study

Abstract

BackgroundThe practice patterns of exercise restrictions for patients with chronic kidney disease have not been adequately evaluated yet; thus, we examined them using a cross-sectional design and explored the factors related with those restrictions.MethodsThe Chronic Kidney Disease Japan Cohort study was a multicentre cohort study of Japanese patients (age 20–75 years) living in Japan. We used the information in the questionnaire on the restriction of physical activities offered by physicians to the patients during enrolment. We initially considered and used the following data as the clinical factors that the physician used for decision making on the directions of restriction of physical activities: age, sex, cause of chronic kidney disease (CKD), comorbid diseases, body mass index (BMI), systolic blood pressure, estimated glomerular filtration rate (eGFR) and urine albumin. The logistic regression model was used to explore the factors and estimate their adjusted odds ratio with regard to physician’s direction of restriction of physical activities.ResultsPhysician’s direction of exercise restrictions was implemented in 9.9% of the participants. In 17 facilities, the proportion of physician’s direction of exercise restriction ranged from 2.9 to 17.8%. The logistic regression analysis showed that the proportion of the factors such as younger age, cardiovascular disease, congestive heart failure and lower eGFR was higher in patients with physician’s direction of exercise restrictions.ConclusionsThe findings from this study suggested the factors related with prescribing exercise restrictions. Further studies examining which patients with CKD need direction of exercise restrictions are needed.

Hyperhomocysteinemia Associated with Low Muscle Mass, Muscle Function in Elderly Hemodialysis Patients: An Analysis of Multiple Dialysis Centers

“…Muscle wasting was the most common condition in elderly people, especially those undergoing hemodialysis with a high prevalence of decreased muscle mass and muscle function, varying from 12.7% to 45.1% in hemodialysis patients [3], the declines in muscle mass and function caused by age [3], comorbidity like diabetes mellitus and infections [4], malnutrition [5], and physical inactivity [6]. In addition, physicians prescribed exercise restrictions in those patients with complications during the treatment [7]. Furthermore, declines of muscle mass and function were exaggerated due to the long bedridden time for the dialysis, low physical function [8], low exercise capacity [9], and increased muscle atrophy [6].…”