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Associations of self-reported physical activity types and levels with quality of life, depression symptoms, and mortality in hemodialysis patients: the DOPPS

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Abstract
Background and objectives: Physical activity has been associated with better health status in diverse populations, but the association in patients on maintenance hemodialysis is less established. Patient-reported physical activities and associations with mortality, health-related quality of life, and depression symptoms in patients on maintenance hemodialysis in 12 countries were examined. Design, setting, participants, & measurements: In total, 5763 patients enrolled in phase 4 of the Dialysis Outcomes and Practice Patterns Study (2009-2011) were classified into five aerobic physical activity categories (never/rarely active to very active) and by muscle strength/flexibility activity using the Rapid Assessment of Physical Activity questionnaire. The Kidney Disease Quality of Life scale was used for health-related quality of life. The Center for Epidemiologic Studies Depression scale was used for depression symptoms. Linear regression was used for associations of physical activity with health-related quality of life and depression symptoms scores. Cox regression was used for association of physical activity with mortality. Results: The median (interquartile range) of follow-up was 1.6 (0.9-2.5) years; 29% of patients were classified as never/rarely active, 20% of patients were classified as very active, and 20.5% of patients reported strength/flexibility activities. Percentages of very active patients were greater in clinics offering exercise programs. Aerobic activity, but not strength/flexibility activity, was associated positively with health-related quality of life and inversely with depression symptoms and mortality (adjusted hazard ratio of death for very active versus never/rarely active, 0.60; 95% confidence interval, 0.47 to 0.77). Similar associations with aerobic activity were observed in strata of age, sex, time on dialysis, and diabetes status. Conclusions: The findings are consistent with the health benefits of aerobic physical activity for patients on maintenance hemodialysis. Greater physical activity was observed in facilities providing exercise programs, suggesting a possible opportunity for improving patient outcomes.
Keywords
CORONARY-HEART-DISEASE, ALL-CAUSE MORTALITY, DIALYSIS OUTCOMES, PRACTICE PATTERNS, KIDNEY-DISEASE, SHORT-FORM, EXERCISE, MEN, POPULATION, SURVIVAL

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Citation

Please use this url to cite or link to this publication:

Chicago
Lopes, Antonio Alberto, Brett Lantz, Hal Morgenstern, Mia Wang, Brian A Bieber, Brenda W Gillespie, Yun Li, et al. 2014. “Associations of Self-reported Physical Activity Types and Levels with Quality of Life, Depression Symptoms, and Mortality in Hemodialysis Patients: The DOPPS.” Clinical Journal of the American Society of Nephrology 9 (10): 1702–1712.
APA
Lopes, A. A., Lantz, B., Morgenstern, H., Wang, M., Bieber, B. A., Gillespie, B. W., Li, Y., et al. (2014). Associations of self-reported physical activity types and levels with quality of life, depression symptoms, and mortality in hemodialysis patients: the DOPPS. CLINICAL JOURNAL OF THE AMERICAN SOCIETY OF NEPHROLOGY, 9(10), 1702–1712.
Vancouver
1.
Lopes AA, Lantz B, Morgenstern H, Wang M, Bieber BA, Gillespie BW, et al. Associations of self-reported physical activity types and levels with quality of life, depression symptoms, and mortality in hemodialysis patients: the DOPPS. CLINICAL JOURNAL OF THE AMERICAN SOCIETY OF NEPHROLOGY. 2014;9(10):1702–12.
MLA
Lopes, Antonio Alberto, Brett Lantz, Hal Morgenstern, et al. “Associations of Self-reported Physical Activity Types and Levels with Quality of Life, Depression Symptoms, and Mortality in Hemodialysis Patients: The DOPPS.” CLINICAL JOURNAL OF THE AMERICAN SOCIETY OF NEPHROLOGY 9.10 (2014): 1702–1712. Print.
@article{5805710,
  abstract     = {Background and objectives: Physical activity has been associated with better health status in diverse populations, but the association in patients on maintenance hemodialysis is less established. Patient-reported physical activities and associations with mortality, health-related quality of life, and depression symptoms in patients on maintenance hemodialysis in 12 countries were examined. 
Design, setting, participants, \& measurements: In total, 5763 patients enrolled in phase 4 of the Dialysis Outcomes and Practice Patterns Study (2009-2011) were classified into five aerobic physical activity categories (never/rarely active to very active) and by muscle strength/flexibility activity using the Rapid Assessment of Physical Activity questionnaire. The Kidney Disease Quality of Life scale was used for health-related quality of life. The Center for Epidemiologic Studies Depression scale was used for depression symptoms. Linear regression was used for associations of physical activity with health-related quality of life and depression symptoms scores. Cox regression was used for association of physical activity with mortality. 
Results: The median (interquartile range) of follow-up was 1.6 (0.9-2.5) years; 29\% of patients were classified as never/rarely active, 20\% of patients were classified as very active, and 20.5\% of patients reported strength/flexibility activities. Percentages of very active patients were greater in clinics offering exercise programs. Aerobic activity, but not strength/flexibility activity, was associated positively with health-related quality of life and inversely with depression symptoms and mortality (adjusted hazard ratio of death for very active versus never/rarely active, 0.60; 95\% confidence interval, 0.47 to 0.77). Similar associations with aerobic activity were observed in strata of age, sex, time on dialysis, and diabetes status. 
Conclusions: The findings are consistent with the health benefits of aerobic physical activity for patients on maintenance hemodialysis. Greater physical activity was observed in facilities providing exercise programs, suggesting a possible opportunity for improving patient outcomes.},
  author       = {Lopes, Antonio Alberto and Lantz, Brett and Morgenstern, Hal and Wang, Mia and Bieber, Brian A and Gillespie, Brenda W and Li, Yun and Painter, Patricia and Jacobson, Stefan H and Rayner, Hugh C and Mapes, Donna L and Vanholder, Raymond and Hasegawa, Takeshi and Robinson, Bruce M and Pisoni, Ronald L},
  issn         = {1555-9041},
  journal      = {CLINICAL JOURNAL OF THE AMERICAN SOCIETY OF NEPHROLOGY},
  language     = {eng},
  number       = {10},
  pages        = {1702--1712},
  title        = {Associations of self-reported physical activity types and levels with quality of life, depression symptoms, and mortality in hemodialysis patients: the DOPPS},
  url          = {http://dx.doi.org/10.2215/CJN.12371213},
  volume       = {9},
  year         = {2014},
}

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