MP406CHANGE IN PHYSICAL ACTIVITY AND RISK OF ALL-CAUSE MORTALITY IN MAINTENANCE HEMODIALYSIS PATIENTS

Introduction and Aims: Physical activity among outpatients undergoing maintenance hemodialysis patients was associated with decreased mortality risk and risk of hospitalization associated with cardio-cerebrovascular events. On the other hand, the association between mortality and a decrease in physical activity based on self-report questionnaire evaluating true physical activity is difficult has been reported previously in community-dwelling individuals. However, the effects of changes in physical activity levels over time on risk of all-cause mortality remains unclear in maintenance hemodialysis patients. We investigated the prognostic significance of change in physical activity, as evaluated with an accelerometer, in regard to all-cause mortality among maintenance hemodialysis patients. Methods: A total of 202 Japanese outpatients undergoing maintenance hemodialysis 3 times a week at a dialysis treatment center between October 2002 and August 2012 were recruited. We excluded patients from our study who had been hospitalized within 3 months before the study or severe comorbidities or who needed help in walking. We measured at clinical characteristics, including age, sex, body mass index (BMI), time on hemodialysis, comorbid conditions, and serum albumin were records from clinical records. A uniaxial accelerometer (Lifecorder; Suzuken Co., Ltd.,Nagoya, Japan) was used to measure patients’ habitual physical activity at 2 points (baseline and 12 months). Patients were instructed to wear the accelerometer continuously during their the number of steps for 7 days. The measurements from 4 non-dialysis days during the week were analyzed. Change in physical activity was determined for each participant on the basis of his/her categorization at median change of physical activity as (1) no change physical activity group (2) a decrease in physical activity group. We truncated the data for the 6-year follow-up period. A Kaplan-Meier estimate of survival and a Cox proportional hazard regression were used to assess the contribution of change of physical activity to all-cause mortality.