Takaaki Watanabe1, Toshiki Kutsuna1,2, Yuta Suzuki1, Manae Harada3, Takahiro Shimoda1, Shohei Yamamoto1,4, Yusuke Isobe1, Keigo Imamura1, Yusuke Matsunaga5,6, Ryota Matsuzawa7, Kentaro Kamiya1,8, Yasuo Takeuchi9, Atsushi Yoshida10, Atsuhiko Matsunaga11,12. 1. Department of Rehabilitation Sciences, Kitasato University Graduate School of Medical Sciences, 1-15-1 Kitasato, Sagamihara, Kanagawa, 252-0373, Japan. 2. Department of Physical Therapy, School of Health Sciences, Tokyo University of Technology, Tokyo, Japan. 3. Department of Rehabilitation, Sagami Circulatory Organ Clinic, Sagamihara, Japan. 4. Department of Epidemiology and Prevention, Center for Clinical Sciences, National Center for Global Health and Medicine, Tokyo, Japan. 5. Department of Clinical Psychology, Tsurukawa Sanatorium Hospital, Tokyo, Japan. 6. Department of Health Science, Kitasato University School of Allied Health Sciences, Sagamihara, Japan. 7. Department of Physical Therapy, School of Rehabilitation, Hyogo University of Health Sciences, Kobe, Japan. 8. Department of Rehabilitation, Kitasato University School of Allied Health Sciences, Sagamihara, Japan. 9. Department of Nephrology in Internal Medicine, Kitasato University School of Medicine, Sagamihara, Japan. 10. Department of Hemodialysis Center, Sagami Circulatory Organ Clinic, Sagamihara, Japan. 11. Department of Rehabilitation Sciences, Kitasato University Graduate School of Medical Sciences, 1-15-1 Kitasato, Sagamihara, Kanagawa, 252-0373, Japan. atsuhikonet@gmail.com. 12. Department of Rehabilitation, Kitasato University School of Allied Health Sciences, Sagamihara, Japan. atsuhikonet@gmail.com.
Abstract
PURPOSE: Most patients receiving hemodialysis have perceived difficulty in mobility tasks, such as basic activities of daily living (ADL), ambulation, and walking up or down stairs, even if they can ambulate independently. Perceived difficulty in performing ADL (ADL difficulty) is reportedly a useful predictor of mortality in older community-dwelling people. However, very few studies have examined the association of ADL difficulty with clinical outcomes in patients receiving hemodialysis. This study aimed to identify the association between ADL difficulty related to mobility tasks of lower limbs and all-cause mortality in patients receiving hemodialysis who are able to ambulate independently. METHODS: This retrospective study analyzed 300 clinically stable outpatients (median age, 65.0 years) receiving hemodialysis. ADL difficulty was evaluated at baseline with a novel questionnaire developed for patients receiving hemodialysis. Lower scores indicated lower ADL, i.e., greater ADL difficulty. The patients were divided into two groups by the median ADL score: a higher ADL group and a lower ADL group. The association between ADL difficulty and all-cause mortality was estimated by Cox regression analyses. RESULTS: Median follow-up duration was 58 months. The incident rates were 0.02 per person-year in the higher ADL group and 0.06 per person-year in the lower ADL group (P < 0.001). After adjusting for the effects of clinical characteristics, the hazard ratio for all-cause mortality in the lower ADL group was 2.70 (95% confidence interval 1.57-4.64) compared with that in the higher ADL group. CONCLUSIONS: Perceived difficulty in mobility tasks was independently associated with all-cause mortality among ambulatory patients receiving hemodialysis.
PURPOSE: Most patients receiving hemodialysis have perceived difficulty in mobility tasks, such as basic activities of daily living (ADL), ambulation, and walking up or down stairs, even if they can ambulate independently. Perceived difficulty in performing ADL (ADL difficulty) is reportedly a useful predictor of mortality in older community-dwelling people. However, very few studies have examined the association of ADL difficulty with clinical outcomes in patients receiving hemodialysis. This study aimed to identify the association between ADL difficulty related to mobility tasks of lower limbs and all-cause mortality in patients receiving hemodialysis who are able to ambulate independently. METHODS: This retrospective study analyzed 300 clinically stable outpatients (median age, 65.0 years) receiving hemodialysis. ADL difficulty was evaluated at baseline with a novel questionnaire developed for patients receiving hemodialysis. Lower scores indicated lower ADL, i.e., greater ADL difficulty. The patients were divided into two groups by the median ADL score: a higher ADL group and a lower ADL group. The association between ADL difficulty and all-cause mortality was estimated by Cox regression analyses. RESULTS: Median follow-up duration was 58 months. The incident rates were 0.02 per person-year in the higher ADL group and 0.06 per person-year in the lower ADL group (P < 0.001). After adjusting for the effects of clinical characteristics, the hazard ratio for all-cause mortality in the lower ADL group was 2.70 (95% confidence interval 1.57-4.64) compared with that in the higher ADL group. CONCLUSIONS: Perceived difficulty in mobility tasks was independently associated with all-cause mortality among ambulatory patients receiving hemodialysis.
Authors: Shannon M Dunlay; Sheila M Manemann; Alanna M Chamberlain; Andrea L Cheville; Ruoxiang Jiang; Susan A Weston; Véronique L Roger Journal: Circ Heart Fail Date: 2015-02-25 Impact factor: 8.790
Authors: S Vanita Jassal; Angelo Karaboyas; Leah A Comment; Brian A Bieber; Hal Morgenstern; Ananda Sen; Brenda W Gillespie; Patricia De Sequera; Mark R Marshall; Shunichi Fukuhara; Bruce M Robinson; Ronald L Pisoni; Francesca Tentori Journal: Am J Kidney Dis Date: 2015-11-21 Impact factor: 8.860
Authors: Ken Farrington; Adrian Covic; Fillipo Aucella; Naomi Clyne; Leen de Vos; Andrew Findlay; Denis Fouque; Tomasz Grodzicki; Osasuyi Iyasere; Kitty J Jager; Hanneke Joosten; Juan Florencio Macias; Andrew Mooney; Dorothea Nitsch; Marijke Stryckers; Maarten Taal; James Tattersall; Dieneke Van Asselt; Nele Van den Noortgate; Ionut Nistor; Wim Van Biesen Journal: Nephrol Dial Transplant Date: 2016-11 Impact factor: 5.992