Background/Aims: Scarce physical activity predicts shorter survival in dialysis patients. However, the relationship between physical (motor) fitness and clinical outcomes has never been tested in these patients. Methods: We tested the predictive power of an established metric of motor fitness, the Six-Minute Walking Test (6MWT), for death, cardiovascular events and hospitalization in 296 dialysis patients who took part in the trial EXCITE (ClinicalTrials.gov Identifier: NCT01255969). Results: During follow up 69 patients died, 90 had fatal and non-fatal cardiovascular events, 159 were hospitalized and 182 patients had the composite outcome. In multivariate Cox models - including the study allocation arm and classical and non-classical risk factors - an increase of 20 walked metres during the 6MWT was associated to a 6% reduction of the risk for the composite end-point (P=0.001) and a similar relationship existed between the 6MWT, mortality (P<0.001) and hospitalizations (P=0.03). A similar trend was observed for cardiovascular events but this relationship did not reach statistical significance (P=0.09). Conclusions: Poor physical performance predicts a high risk of mortality, cardiovascular events and hospitalizations in dialysis patients. Future studies, including phase-2 EXCITE, will assess whether improving motor fitness may translate into better clinical outcomes in this high risk population.

Physical performance and clinical outcomes in dialysis patients: A secondary analysis of the excite trial / C. Torino, F. Manfredini, D. Bolignano, F. Aucella, R. Baggetta, A. Barillà, Y. Battaglia, S. Bertoli, G. Bonanno, P. Castellino, D. Ciurlino, A. Cupisti, G. D'Arrigo, L. De Paola, F. Fabrizi, P. Fatuzzo, G. Fuiano, L. Lombardi, G. Lucisano, P. Messa, R. Rapanà, F. Rapisarda, S. Rastelli, L. Rocca-Rey, C. Summaria, A. Zuccalà, G. Tripepi, L. Catizone, C. Zoccali, F. Mallamaci. - In: KIDNEY & BLOOD PRESSURE RESEARCH. - ISSN 1420-4096. - 39:2-3(2014), pp. 205-211. [10.1159/000355798]

Physical performance and clinical outcomes in dialysis patients: A secondary analysis of the excite trial

P. Messa;L. Rocca-Rey;
2014

Abstract

Background/Aims: Scarce physical activity predicts shorter survival in dialysis patients. However, the relationship between physical (motor) fitness and clinical outcomes has never been tested in these patients. Methods: We tested the predictive power of an established metric of motor fitness, the Six-Minute Walking Test (6MWT), for death, cardiovascular events and hospitalization in 296 dialysis patients who took part in the trial EXCITE (ClinicalTrials.gov Identifier: NCT01255969). Results: During follow up 69 patients died, 90 had fatal and non-fatal cardiovascular events, 159 were hospitalized and 182 patients had the composite outcome. In multivariate Cox models - including the study allocation arm and classical and non-classical risk factors - an increase of 20 walked metres during the 6MWT was associated to a 6% reduction of the risk for the composite end-point (P=0.001) and a similar relationship existed between the 6MWT, mortality (P<0.001) and hospitalizations (P=0.03). A similar trend was observed for cardiovascular events but this relationship did not reach statistical significance (P=0.09). Conclusions: Poor physical performance predicts a high risk of mortality, cardiovascular events and hospitalizations in dialysis patients. Future studies, including phase-2 EXCITE, will assess whether improving motor fitness may translate into better clinical outcomes in this high risk population.
Physical performance; Six-minute walking test; Chronic kidney disease; Dialysis; Clinical outcomes
Settore MED/14 - Nefrologia
2014
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Utilizza questo identificativo per citare o creare un link a questo documento: https://hdl.handle.net/2434/588729
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