Kidney & Blood Pressure Research (Jul 2014)

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

  • Claudia Torino,
  • Fabio Manfredini,
  • Davide Bolignano,
  • Filippo Aucella,
  • Rossella Baggetta,
  • Antonio Barillà,
  • Yuri Battaglia,
  • Silvio Bertoli,
  • Graziella Bonanno,
  • Pietro Castellino,
  • Daniele Ciurlino,
  • Adamasco Cupisti,
  • Graziella D'Arrigo,
  • Luciano De Paola,
  • Fabrizio Fabrizi,
  • Pasquale Fatuzzo,
  • Giorgio Fuiano,
  • Luigi Lombardi,
  • Gaetano Lucisano,
  • Piergiorgio Messa,
  • Renato Rapanà,
  • Francesco Rapisarda,
  • Stefania Rastelli,
  • Lisa Rocca-Rey,
  • Chiara Summaria,
  • Alessandro Zuccalà,
  • Giovanni Tripepi,
  • Luigi Catizone,
  • Carmine Zoccali,
  • Francesca Mallamaci

DOI
https://doi.org/10.1159/000355798
Journal volume & issue
Vol. 39, no. 2-3
pp. 205 – 211

Abstract

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Background/Aims: 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. Methods: 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). Results: 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 (PConclusions: 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.

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