Association between sedentary behavior, physical activity, and quality of life in renal patients undergoing hemodialysis

Abstract

End-stage chronic kidney disease (CKD) treated with hemodialysis (HD) is associated with reduced physical activity (PA) and increased sedentary behavior (SB), both of which can negatively impact quality of life (QoL). The aim of this study was to examine the association between levels of PA, SB (assessed through sitting time and screen time), and QoL in patients with CKD undergoing HD. This was a cross-sectional study involving 165 HD patients from a public hospital in southern Brazil. Validated questionnaires were applied (IPAQ-long form and KDQOL-SF 1.3). Patients with better quality of life showed higher levels of total physical activity (p = 0.019), walking (p = 0.044), and lower sitting time (p = 0.002) and screen time (p = 0.025). Better quality of life was significantly associated with walking more than 100 MET-min/week (OR = 2.46), engaging in moderate-to-vigorous physical activity over 1200 MET-min/week (RR = 1.67), and spending less sedentary time (<6 h/day) and screen time (<4 h/day). ROC curve analyses identified the following optimal cut-off points: walking ≥132 MET-min/week, moderate-to-vigorous physical activity ≥1100 MET-min/week, sitting time ≤420 min/day, and screen time ≤3.7 h/day. In conclusion, among patients with CKD on HD, higher PA levels and reduced sedentary behavior are associated with better QoL. These findings provide practical thresholds that can guide personalized clinical interventions in nephrology.