Physical Activity in Patients Treated With Peritoneal Dialysis

Abstract

Introduction and Aims: Physical inactivity, a risk factor for mortality in dialyzed patients, has been essentially studied in hemodialysis patients (HD).We aimed to assess physical activity from peritoneal dialysis (PD) patients included in the Step by Step initiative, a large cohort of maintenance dialysis (MD) patients. Methods: All French nephrologists were invited to participate in a national prospective multicenter observational trial. 149 investigators included 1163 adult prevalent (> 3 months) MD patients. Physical activity was assessed by the number of daily steps measured by a pedometer (NO PE317C multifunction pedometer, USA) for 7 consecutive days. All PD patients from the cohort (n=63, 5.4%) were analyzed and compared with - randomly-matched computer-selected HD patients (n=123), (1:2 ratio), by age (10-year intervals) and dialysis vintage (3-months intervals), which mostly determined daily step number in the whole cohort. Results: Median age (57 yr) and dialysis vintage (1 yr) were not different in PD and HD patients, as expected. Sex ratio (males: 60% in PD vs 68% in HD), prevalence of diabetes (30% vs 25%), ischemic heart, peripheral arterial, neurological and joint diseases were comparable. The groups only differed by the prevalence of hypertension (89 vs 63%, p: 0.0002) and median body mass index (25.9 vs 24.2 kg/m2, p: 0.036). Median daily step number was comparable in PD vs HD patients (3321; Q1 1478-Q3 5926 vs 3903; Q1 2156-Q3 7346; p: 0.193). 64% PD vs 61 % HD patients were sedentary (< 5000 steps/d), and 22% PD vs 16% HD patients had a low physical activity (> 5000 and < 7500 steps/d). Conclusions: This study is the first to compare physical activity of PD vs matched HD patients. Despite a less immobilizing treatment, 86% of PD patients had a sedentary/ low activity profile, similar to HD patients. These data confirm the need to promote physical activity in all MD patients, independent of the dialysis technique.