Interventions to increase physical activity level in patients with whole spectrum chronic kidney disease: a systematic review and meta-analysis

Association between physical activity and quality of life in haemodialysed and peritoneal dialyzed patients in Hungary

BACKGROUND

Patients with end-stage kidney disease (ESKD) receiving peritoneal dialysis (PD) or haemodyalisis (PD) appear to be less physically active than healthy persons, a situation that could lead to reductions in quality of life. The aim of the present study was to assess and compare physical activity and health-related quality of life in renal patients on HD and PD programs.

METHODS

In May 2020, 130 patients (106 HD and 24 PD) were enrolled in a study of chronic dialysis programs. All participants received a questionnaire containing information on demographics, treatment, and co-morbidities. Physical activity was assessed using the International Physical Activity Questionnaire (IPAQ) short form, and quality of life was measured using the Kidney Disease Quality of Life-Short Form 12 (KDQOL-SF-12) questionnaire comprising mental (MCS) and physical components (PCS). Non-parametric statistical tests were executed with 0.05 as the level of significance.

RESULTS

The physical activity of patients treated in both HD and PD programs could be considered as low, without a statistically significant difference between the two modalities. For the quality of life measures, we found a significant (p = .004) difference regarding Physical Component Summary (PCS) scores, with higher PCS scores in patients treated in the PD programme compared to HD. Furthermore, higher physical activity levels were associated with better quality of life parameters in both groups.

CONCLUSION

This study confirms the importance of physical activity among dialysis patients with ESKD, suggesting that greater activity could be associated with a better quality of life.

Comparisons of Intradialytic Exercise Versus Home-Based Exercise in Hemodialysis Patients: A Narrative Review

With the increasing prevalence of end-stage kidney disease, the number of patients requiring hemodialysis (HD) continues to rise. While life-sustaining, HD is often associated with adverse effects such as muscle loss, physical deconditioning, fatigue, and compromised health-related quality of life (HRQoL). Recent research suggests that intradialytic exercise (IDE) and home-based exercise (HBE) may mitigate these adverse effects and improve patient outcomes. However, the existing literature mainly focuses on the outcomes of both exercises, whereas the comparison of types is often omitted. Hence, this review consolidates findings from studies investigating the effectiveness, implementation, safety, feasibility, and adherence of different types of IDE and HBE in HD patients. Overall, the current literature bolsters the significance of IDE and HBE for improving health in HD patients. IDE and HBE enhance physical function, cardiopulmonary capacity, HRQoL, and cognitive well-being. Some research proposed an indirect link between IDE and survival rates. Despite these benefits, challenges remain in implementing these exercise modalities, including patient adherence and the feasibility of routine exercise during HD sessions. Integrating these exercises into routine care allows healthcare providers to enhance outcomes for HD patients. Further research is suggested to optimize exercise protocols and explore long-term effects and cost-effectiveness.

Examining Self-Reported Physical Activity Levels Among Kidney Disease Patients in the United States Using the Behavioral Risk Factor Surveillance System (BRFSS) Database: A Retrospective Study

INTRODUCTION

Kidney diseases have a gradual and subtle onset, which usually results in end-stage renal disease with patients requiring renal replacement therapy. Though pharmacotherapy plays a crucial role, integrating lifestyle modifications like increased physical exercise has been associated with significant improvement in health for kidney disease patients.

AIMS

This study aims to retrospectively analyze the prevalence of self-reported physical activity among patients of kidney disease in the United States, based on demographic, socioeconomic, and healthcare access variables for the year 2021.

METHODOLOGY

Data was extracted from the Behavioral Risk Factor Surveillance System Web Enabled Analysis Tool (BRFSS WEAT) for the year 2021. Descriptive data, including numbers and percentages, was generated for each variable using cross-tabulations in the BRFSS WEAT. The data was stored in Microsoft Excel (Microsoft Corporation, Redmond, WA, USA), and statistical analysis was conducted using R version 4.3.1 (R Foundation for Statistical Computing, Vienna, Austria, https://www.R-project.org/). Statistical tests employed included the Chi-square test and Fisher's exact test to ensure robust and reliable results.

RESULTS

A total of 436,057 people participated in the BRFSS study. Out of this, 17,054 (39%) self-identified to the question "ever told you had kidney disease." In the past month, 10,004 (58.7%) participants having kidney disease were involved in physical activity, whereas 7,050 (41.3%) were not. Also, the level of physical activity among kidney disease participants was highest in ages 18-25 (75.5%), male gender (63.6%), White non-Hispanic race (59.4%), patients having advanced education (64.2%), employed (72.6%), high income (82.1%), and having routine checkup within the past one year (8,957, 58.3%).

CONCLUSION

Kidney disease patients in the United States who self-reported physical activity were found to have statistical significance between various demographic, socioeconomic, and last routine checkup variables. Prospectively, interventions must be designed to increase physical activity among kidney disease patients with a focus on high-risk demographic groups like older adults, people with lower socioeconomic status, and people who don't get regular checkups.