Sex Difference in the Association between Physical Activity and All-Cause Mortality in Ambulatory Patients with Chronic Kidney Disease

Int J Environ Res Public Health. 2021 Apr 1;18(7):3698. doi: 10.3390/ijerph18073698.

Abstract

(1) Background: The purpose of this article was to investigate the association between self-reported physical activity (PA) and all-cause mortality in ambulatory patients with chronic kidney disease (CKD), stage 4-5 including maintenance dialysis. (2) Methods: Ambulatory patients with CKD (eGFR < 30 mL/min/1.73 m2) with conservative treatment or chronic dialysis were included. PA was assessed using the Saltin-Grimby Physical Activity Level Scale. A Cox proportional hazards regression model--adjusted for age, sex, plasma-albumin, body mass index, socioeconomic status, and treatment--was applied. (3) Results: Participants (n = 374) were followed 39 ± 15 months from entry to death or censoring. Throughout the study period of 39 months, 156 deaths (42%) were registered. Regarding physical activity, 128 (34%) of the participants were inactive, 212 (57%) were moderately active, and 34 (9%) were highly or vigorously active. Moderate PA was associated with a decreased mortality risk in women (n = 150) compared to inactivity (HR 0.27 (0.15; 0.51), p < 0.001), whereas a high/vigorous level of PA was not significantly associated with mortality risk compared to inactivity. In men (n = 224), the associations between PA levels and mortality risk were not significant. (4) Conclusions: Moderate PA was associated with reduced all-cause mortality in ambulatory women with stage 4-5 CKD with or without maintenance dialysis treatment. Physical activity was not significantly associated with mortality in men.

Keywords: chronic kidney failure; cox proportional hazards models; dialysis; physical activity; survival analyses.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Exercise
  • Female
  • Humans
  • Kidney Failure, Chronic*
  • Male
  • Proportional Hazards Models
  • Renal Dialysis
  • Renal Insufficiency, Chronic* / therapy
  • Risk Factors
  • Sex Characteristics