Dissemin is shutting down on January 1st, 2025

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Karger Publishers, Kidney and Blood Pressure Research, 2-3(39), p. 205-211, 2014

DOI: 10.1159/000355798

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Physical Performance and Clinical Outcomes in Dialysis Patients: A Secondary Analysis of the Excite Trial

This paper is made freely available by the publisher.
This paper is made freely available by the publisher.

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Abstract

<b><i>Background/Aims: </i></b>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. <b><i>Methods: </i></b>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). <b><i>Results: </i></b>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). <b><i>Conclusions: </i></b>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.