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Tabibi MA, Samouei R, Salimian N, Shahidi S, Atapour A, Nazemi F, Ghenaat M, Nikbakht S, Sarbazi MH, Soleymany M, Roshanaeian Z, Khajeheian B, Khaki Z, Sokani AS, Ebrahimi R, Ahmadi S. Validity and reliability of Persian version of Low Physical Activity Questionnaire (LoPAQ). BMC Nephrol 2024; 25:178. [PMID: 38778292 PMCID: PMC11112922 DOI: 10.1186/s12882-024-03615-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/09/2024] [Accepted: 05/15/2024] [Indexed: 05/25/2024] Open
Abstract
BACKGROUND The Low Physical Activity Questionnaire (LoPAQ) was specifically developed to measure the low activity level observed in extremely inactive hemodialysis (HD) patients. This study aims to evaluate reliability and validity of Persian version of the LoPAQ. METHODS This study was a cross sectional study, conducted in three HD centers in Iran. The LoPAQ was translated into Persian. After cultural adaptions, it was filled out by 120 HD patiens. Convergent validity, was evaluated by calculating the correlations among the Persian version of the LoPAQ and Persian version of the Community Healthy Adults Model Program for Seniors (CHAMPS) questionnaire, physical function scale of the SF-36 and physical function (Short Physical Performance Battery (SPPB) test) using Spearman's correlation coefficients. The test-retest reliability was analyzed using the intraclass correlation coefficient (ICC). RESULTS In total, 109 patients completed all of the questionnaires, took part in physical performance tests and had valid data. Their mean age was 64 ± 11 years, with a dialysis history of 31 ± 10 months. For total calories, there was a strong correlation between the Persian version of the LoPAQ and CHAMPS-measured physical activity (rho = 0.85, p < 0.001). In addition, the higher physical activity level reported by Persian version of the LoPAQ was also correlated with better self-reported physical function (rho = 0.7, p < 0.001) and better physical performance (rho = 0.67, p < 0.001). The ICC ranged from 0.65 to 0.78, indicating strong reliability. CONCLUSION The assessment of the validity and reliability of the Persian version of the questionnaire confirmed its suitability for evaluating the level of physical activity. TRIAL REGISTRATION ClinicalTrials.gov Identifier: NCT05930964, Registered on 05/07/2023. Registered trial name: Validity and Reliability of Persian Version of Low Physical Activity Questionnaire (LoPAQ).
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Affiliation(s)
- Mohammad Ali Tabibi
- Department of Exercise Physiology, Pardis Specialized Wellness Institute, Isfahan, Iran.
| | - Rahele Samouei
- Social Determinants of Health Research Center, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Nasrin Salimian
- Department of Research and Development, Pardis Specialized Wellness Institute, Isfahan, Iran
| | - Shahrzad Shahidi
- Isfahan Kidney Diseases Research Center, Internal Medicine Department, Khorshid Hospital, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Abdolamir Atapour
- Isfahan Kidney Diseases Research Center, Internal Medicine Department, Khorshid Hospital, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Farzad Nazemi
- Department of Exercise Physiology, Pardis Specialized Wellness Institute, Isfahan, Iran
| | - Mahsa Ghenaat
- Department of Exercise Physiology, Pardis Specialized Wellness Institute, Isfahan, Iran
| | - Saghar Nikbakht
- Department of Kinesiology, Pardis Specialized Wellness Institute, Isfahan, Iran
| | | | - Mahsa Soleymany
- Department of Exercise Physiology, Pardis Specialized Wellness Institute, Isfahan, Iran
| | - Zahra Roshanaeian
- Department of Sport Nutrition, Pardis Specialized Wellness Institute, Isfahan, Iran
| | - Behnaz Khajeheian
- Department of Kinesiology, Pardis Specialized Wellness Institute, Isfahan, Iran
| | - Zahra Khaki
- Department of Exercise Physiology, Pardis Specialized Wellness Institute, Isfahan, Iran
| | - Ali Sadeghi Sokani
- Department of Exercise Physiology, Pardis Specialized Wellness Institute, Isfahan, Iran
| | - Reyhane Ebrahimi
- Department of Kinesiology, Pardis Specialized Wellness Institute, Isfahan, Iran
| | - Saghar Ahmadi
- Department of Health and Palliative Care, Pardis Specialized Wellness Institute, Isfahan, Iran
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2
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Chu NM, Hong J, Harasemiw O, Chen X, Fowler KJ, Dasgupta I, Bohm C, Segev DL, McAdams-DeMarco MA. Chronic kidney disease, physical activity, and cognitive function in older adults- results from the National Health and Nutrition Examination Survey (2011-2014). Nephrol Dial Transplant 2021; 37:2180-2189. [PMID: 34850174 DOI: 10.1093/ndt/gfab338] [Citation(s) in RCA: 21] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/24/2021] [Indexed: 11/13/2022] Open
Abstract
BACKGROUND Cognitive impairment is common among persons with chronic kidney disease (CKD) due in part to reduced kidney function. Given that physical activity (PA) is known to mitigate cognitive decline, we examined whether associations between CKD stage and global/domain-specific cognitive function differs by PA. METHODS We leveraged 3,223 participants (aged≥60years) enrolled in National Health and Nutrition Examination Survey (NHANES,2011-2014), with at least one measure of objective cognitive function (immediate recall [CERAD-WL], delayed recall [CERAD-DR], verbal fluency [AF], executive function/processing speed [DSST], global [average of 4 tests]) or self-perceived memory decline [SCD]. We quantified the association between CKD stage (no CKD: eGFR≥60 mL/min/1.73m2 and albuminuria(ACR)<30 mg/g; stage G1-G3: eGFR≥60mL/min/1.73m2 and ACR≥30mg/g or eGFR 30-59mL/min/1.73m2; stage G4-G5: eGFR<30mL/min/1.73m2) and cognitive function using linear regression (objective measures) and logistic regression (SCD), accounting for sampling weights for nationally-representative estimates. We tested whether associations differed by physical activity (Global Physical Activity Questionnaire, high PA≥600MET*min/week vs. low PA<600MET*min/week) using a Wald test. RESULTS Among NHANES participants, 34.9% had CKD stageG1-G3, 2.6% had stageG4-G5, and 50.7% had low PA. CKD stageG4-G5 was associated with lower global cognitive function (difference = -0.38SD, 95%CI:-0.62,-0.15). This association differed by PA (pinteraction = 0.01). Specifically, among participants with low PA, those with CKD stageG4-G5 had lower global cognitive function (difference = -0.57SD, 95%CI: -0.82,-0.31) compared to those without CKD. Among those with high PA, no difference was found (difference = 0.10SD, 95%CI:-0.29,0.49). Similarly, CKD stage was only associated with immediate recall, verbal fluency, executive function, and processing speed among those with low PA; no associations were observed for delayed recall or self-perceived memory decline. CONCLUSIONS CKD is associated with lower objective cognitive function among those with low, but not high PA. Clinicians should consider screening older patients with CKD who have low PA for cognitive impairment and encourage them to meet PA guidelines.
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Affiliation(s)
- Nadia M Chu
- Department of Surgery, Johns Hopkins University School of Medicine, Baltimore, Maryland, USA.,Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland, USA
| | - Jingyao Hong
- Department of Surgery, Johns Hopkins University School of Medicine, Baltimore, Maryland, USA
| | - Oksana Harasemiw
- Department of Internal Medicine, University of Manitoba, Winnipeg, Canada
| | - Xiaomeng Chen
- Department of Surgery, Johns Hopkins University School of Medicine, Baltimore, Maryland, USA
| | - Kevin J Fowler
- Principal, The Voice of the Patient, Inc. Chicago, Illinois, USA
| | - Indranil Dasgupta
- University of Warwick, Heartlands Hospital Birmingham and Warwick Medical School, West Midlands, England, UK
| | - Clara Bohm
- Department of Internal Medicine, University of Manitoba, Winnipeg, Canada
| | - Dorry L Segev
- Department of Surgery, Johns Hopkins University School of Medicine, Baltimore, Maryland, USA.,Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland, USA
| | - Mara A McAdams-DeMarco
- Department of Surgery, Johns Hopkins University School of Medicine, Baltimore, Maryland, USA.,Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland, USA
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Avin KG, Hughes MC, Chen NX, Srinivasan S, O’Neill KD, Evan AP, Bacallao RL, Schulte ML, Moorthi RN, Gisch DL, Perry CGR, Moe SM, O’Connell TM. Skeletal muscle metabolic responses to physical activity are muscle type specific in a rat model of chronic kidney disease. Sci Rep 2021; 11:9788. [PMID: 33963215 PMCID: PMC8105324 DOI: 10.1038/s41598-021-89120-8] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/21/2020] [Accepted: 04/14/2021] [Indexed: 02/03/2023] Open
Abstract
Chronic kidney disease (CKD) leads to musculoskeletal impairments that are impacted by muscle metabolism. We tested the hypothesis that 10-weeks of voluntary wheel running can improve skeletal muscle mitochondria activity and function in a rat model of CKD. Groups included (n = 12-14/group): (1) normal littermates (NL); (2) CKD, and; (3) CKD-10 weeks of voluntary wheel running (CKD-W). At 35-weeks old the following assays were performed in the soleus and extensor digitorum longus (EDL): targeted metabolomics, mitochondrial respiration, and protein expression. Amino acid-related compounds were reduced in CKD muscle and not restored by physical activity. Mitochondrial respiration in the CKD soleus was increased compared to NL, but not impacted by physical activity. The EDL respiration was not different between NL and CKD, but increased in CKD-wheel rats compared to CKD and NL groups. Our results demonstrate that the soleus may be more susceptible to CKD-induced changes of mitochondrial complex content and respiration, while in the EDL, these alterations were in response the physiological load induced by mild physical activity. Future studies should focus on therapies to improve mitochondrial function in both types of muscle to determine if such treatments can improve the ability to adapt to physical activity in CKD.
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Affiliation(s)
- Keith G. Avin
- Division of Nephrology, Indiana University School of Medicine, 950 W. Walnut St., R2 202, Indianapolis, IN 46202 USA ,Department of Physical Therapy, Indiana University School of Health and Human Sciences, Indianapolis, IN USA ,Roudebush Veterans Affairs Medical Center, Indianapolis, IN USA
| | - Meghan C. Hughes
- School of Kinesiology and Health Science, Muscle Health Research Centre, York University, Toronto, ON Canada
| | - Neal X. Chen
- Division of Nephrology, Indiana University School of Medicine, 950 W. Walnut St., R2 202, Indianapolis, IN 46202 USA ,Roudebush Veterans Affairs Medical Center, Indianapolis, IN USA
| | - Shruthi Srinivasan
- Division of Nephrology, Indiana University School of Medicine, 950 W. Walnut St., R2 202, Indianapolis, IN 46202 USA ,Roudebush Veterans Affairs Medical Center, Indianapolis, IN USA
| | - Kalisha D. O’Neill
- Division of Nephrology, Indiana University School of Medicine, 950 W. Walnut St., R2 202, Indianapolis, IN 46202 USA ,Roudebush Veterans Affairs Medical Center, Indianapolis, IN USA
| | - Andrew P. Evan
- Department of Anatomy and Cell Biology, Indiana University School of Medicine, Indianapolis, IN USA
| | - Robert L. Bacallao
- Division of Nephrology, Indiana University School of Medicine, 950 W. Walnut St., R2 202, Indianapolis, IN 46202 USA ,Roudebush Veterans Affairs Medical Center, Indianapolis, IN USA
| | - Michael L. Schulte
- Department of Radiology and Imaging Sciences, Indiana University School of Medicine, Indianapolis, IN USA
| | - Ranjani N. Moorthi
- Division of Nephrology, Indiana University School of Medicine, 950 W. Walnut St., R2 202, Indianapolis, IN 46202 USA
| | - Debora L. Gisch
- Departamento de Engenharia Mecânica, Universidade Federal do Rio Grande do Sul, Porto Alegre, RS Brazil
| | - Christopher G. R. Perry
- School of Kinesiology and Health Science, Muscle Health Research Centre, York University, Toronto, ON Canada
| | - Sharon M. Moe
- Division of Nephrology, Indiana University School of Medicine, 950 W. Walnut St., R2 202, Indianapolis, IN 46202 USA ,Roudebush Veterans Affairs Medical Center, Indianapolis, IN USA ,Department of Anatomy and Cell Biology, Indiana University School of Medicine, Indianapolis, IN USA
| | - Thomas M. O’Connell
- Department of Otolaryngology, Head and Neck Surgery, Indiana University School of Medicine, Indianapolis, IN USA
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Young HML, Orme MW, Song Y, Dungey M, Burton JO, Smith AC, Singh SJ. Standardising the measurement of physical activity in people receiving haemodialysis: considerations for research and practice. BMC Nephrol 2019; 20:450. [PMID: 31801480 PMCID: PMC6894215 DOI: 10.1186/s12882-019-1634-1] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/15/2019] [Accepted: 11/20/2019] [Indexed: 01/09/2023] Open
Abstract
BACKGROUND Physical activity (PA) is exceptionally low amongst the haemodialysis (HD) population, and physical inactivity is a powerful predictor of mortality, making it a prime focus for intervention. Objective measurement of PA using accelerometers is increasing, but standard reporting guidelines essential to effectively evaluate, compare and synthesise the effects of PA interventions are lacking. This study aims to (i) determine the measurement and processing guidance required to ensure representative PA data amongst a diverse HD population, and; (ii) to assess adherence to PA monitor wear amongst HD patients. METHODS Clinically stable HD patients from the UK and China wore a SenseWear Armband accelerometer for 7 days. Step count between days (HD, Weekday, Weekend) were compared using repeated measures ANCOVA. Intraclass correlation coefficients (ICCs) determined reliability (≥0.80 acceptable). Spearman-Brown prophecy formula, in conjunction with a priori ≥ 80% sample size retention, identified the minimum number of days required for representative PA data. RESULTS Seventy-seven patients (64% men, mean ± SD age 56 ± 14 years, median (interquartile range) time on HD 40 (19-72) months, 40% Chinese, 60% British) participated. Participants took fewer steps on HD days compared with non-HD weekdays and weekend days (3402 [95% CI 2665-4140], 4914 [95% CI 3940-5887], 4633 [95% CI 3558-5707] steps/day, respectively, p < 0.001). PA on HD days were less variable than non-HD days, (ICC 0.723-0.839 versus 0.559-0.611) with ≥ 1 HD day and ≥ 3 non-HD days required to provide representative data. Using these criteria, the most stringent wear-time retaining ≥ 80% of the sample was ≥7 h. CONCLUSIONS At group level, a wear-time of ≥7 h on ≥1HD day and ≥ 3 non-HD days is required to provide reliable PA data whilst retaining an acceptable sample size. PA is low across both HD and non- HD days and future research should focus on interventions designed to increase physical activity in both the intra and interdialytic period.
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Affiliation(s)
- Hannah M L Young
- Department of Respiratory Science, University of Leicester, Leicester Kidney Lifestyle Team, Academic Unit, Leicester General Hospital, Gwendolen Road, Leicester, LE4 5PW, UK.
| | - Mark W Orme
- Department of Respiratory Science, University of Leicester, Leicester Kidney Lifestyle Team, Academic Unit, Leicester General Hospital, Gwendolen Road, Leicester, LE4 5PW, UK
- Centre for Exercise and Rehabilitation Science, NIHR Leicester Biomedical Research Centre - Respiratory, Glenfield Hospital, University Hospitals of Leicester NHS Trust, Leicester, UK
| | - Yan Song
- Department of Health Sciences, University of Leicester, Leicester, UK
- Nantong University, Nantong, China
| | - Maurice Dungey
- Department of Cardiovascular Science, University of Leicester, Leicester, UK
| | - James O Burton
- Department of Cardiovascular Science, University of Leicester, Leicester, UK
- National Centre for Sport and Exercise Medicine, Loughborough University, Loughborough, UK
| | - Alice C Smith
- Department of Health Sciences, University of Leicester, Leicester, UK
| | - Sally J Singh
- Department of Respiratory Science, University of Leicester, Leicester Kidney Lifestyle Team, Academic Unit, Leicester General Hospital, Gwendolen Road, Leicester, LE4 5PW, UK
- Centre for Exercise and Rehabilitation Science, NIHR Leicester Biomedical Research Centre - Respiratory, Glenfield Hospital, University Hospitals of Leicester NHS Trust, Leicester, UK
- National Centre for Sport and Exercise Medicine, Loughborough University, Loughborough, UK
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5
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Management of anxiety and depression in haemodialysis patients: the role of non-pharmacological methods. Int Urol Nephrol 2018; 51:113-118. [DOI: 10.1007/s11255-018-2022-7] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/01/2018] [Accepted: 10/29/2018] [Indexed: 01/13/2023]
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Dam M, Neelemaat F, Struijk-Wielinga T, Weijs PJ, van Jaarsveld BC. Physical performance and protein-energy wasting in patients treated with nocturnal haemodialysis compared to conventional haemodialysis: protocol of the DiapriFIT study. BMC Nephrol 2017; 18:144. [PMID: 28460640 PMCID: PMC5412044 DOI: 10.1186/s12882-017-0562-1] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/29/2016] [Accepted: 04/20/2017] [Indexed: 01/27/2023] Open
Abstract
BACKGROUND Poor physical performance and protein-energy wasting (PEW) are health issues of major concern in haemodialysis patients. The conventional haemodialysis (CHD) regime, three times per week 3-5 h, is subject of discussion because of high morbidity and mortality rates. When patients switch from CHD to longer dialysis sessions, i.e. nocturnal haemodialysis (NHD), improvement in protein intake and increase in body weight is seen. However, it is unclear whether physical performance and more important aspects of PEW, such as body composition, improve as well. Therefore, the aim of this study is to investigate whether physical performance improves and PEW decreases, when patients switch from CHD to NHD. A second aim is to assess the influence of NHD on the biomarkers fibroblast growth factor-23 and sclerostin which are thought to be associated with malnutrition and mortality in patients on haemodialysis. METHODS This study is a prospective multicentre cohort study with an inclusion aim of 50 patients: 25 patients in a control group (three times per week, 3-5 h CHD) and 25 patients in a nocturnal group (three times per week, 7-9 h NHD). Primary outcome is change in physical performance, measured by the Short Physical Performance Battery. Additional measurements are a 6-min walk test, handgrip strength, a physical activity questionnaire and physical activity monitoring. The secondary outcome of the study is PEW, which will be evaluated by body weight, dual-energy X-ray absorptiometry, bio-electrical impedance spectroscopy, mid-upper arm muscle circumference, subjective global assessment, visual analogue scale for appetite and dietary records. Laboratory measurements including fibroblast growth factor-23 and sclerostin, and quality of life assessed with the Kidney Disease Quality of Life-Short Form are also studied. In every patient, four repeated measurements will be performed during one year of follow-up. DISCUSSION This study will investigate whether physical performance improves and PEW decreases when patients switch from CHD to NHD, compared to a control group who continue treatment with CHD. Strengths of this study are the comparison with a conventional haemodialysis cohort, and the broad variety of objective measurements combined with patient-reported outcomes of physical performance and PEW. TRIAL REGISTRATION NTR4715 , Netherlands Trial Register. Registered 30 July 2014.
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Affiliation(s)
- Manouk Dam
- VU University Medical Centre, department of Nutrition and Dietetics, Boelelaan 1117, 1081HV, Amsterdam, The Netherlands.
| | - Floor Neelemaat
- VU University Medical Centre, department of Nutrition and Dietetics, Boelelaan 1117, 1081HV, Amsterdam, The Netherlands
| | - Trudeke Struijk-Wielinga
- VU University Medical Centre, department of Nutrition and Dietetics, Boelelaan 1117, 1081HV, Amsterdam, The Netherlands
| | - Peter J Weijs
- VU University Medical Centre, department of Nutrition and Dietetics, Boelelaan 1117, 1081HV, Amsterdam, The Netherlands
| | - Brigit C van Jaarsveld
- VU University Medical Centre, department of Nephrology, Boelelaan 1117, 1081HV, Amsterdam, The Netherlands
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Liao YC, Chou CY, Chang CT, Li TC, Sun MF, Chang HH, Tsai FJ, Yen HR. Qi deficiency is associated with depression in chronic hemodialysis patients. Complement Ther Med 2016; 30:102-106. [PMID: 28137519 DOI: 10.1016/j.ctim.2016.12.008] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/16/2016] [Revised: 10/28/2016] [Accepted: 12/24/2016] [Indexed: 11/17/2022] Open
Abstract
OBJECTIVE Depression is a common bio-psycho-social problem in hemodialysis (HD) patients. Traditional Chinese medicine has been used for symptom management in patients with depression. Identification of the specific constitution in traditional Chinese medicine is critical for personalized care. However, the association between depression and specific constitution in HD patients is unknown. METHODS We conducted a cross-sectional study in all chronic HD patients (HD for more than 3 months) at China Medical University Hospital in Taiwan. The depression symptom severity was determined using the Beck Depression Inventory II (BDI-II). Clinical patterns in Chinese medicine were determined using the Constitution in Chinese Medicine Questionnaire. The association between constitution and depression was analyzed using logistic regression. RESULTS We recruited 467 chronic hemodialysis patients, including 219 females and 248 males, with a mean age of 63±12years. The mean duration of HD was 5.8 years. The mean score for the BDI-II was 11 (interquartile range 8-14). The major constitution was Yang-deficiency (43.7%) among these chronic HD patients. Qi-deficiency was correlated with a duration of HD of more than 5.8 years (p=0.04). Qi-deficiency [odds ratio (OR): 4.05, 95% confidence interval (CI): 1.69-9.72, p<0.01] was also associated with depression in logistic regression with adjustments for confounders, including calcium, phosphorus and hemoglobin levels. CONCLUSION Qi-deficiency constitution in Chinese medicine is associated with depression in chronic HD patients. Further studies are needed to determine whether treating Qi-deficiency integrating Chinese medicine treatment can improve patients' depression symptoms.
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Affiliation(s)
- Yuan-Ching Liao
- Department of Chinese Medicine, China Medical University Hospital, Taichung 404, Taiwan
| | - Che-Yi Chou
- Kidney Institute and Division of Nephrology, China Medical University Hospital, Taichung 404, Taiwan; School of Medicine, College of Medicine, China Medical University, Taichung 404, Taiwan
| | - Chiz-Tzung Chang
- Kidney Institute and Division of Nephrology, China Medical University Hospital, Taichung 404, Taiwan; School of Medicine, College of Medicine, China Medical University, Taichung 404, Taiwan
| | - Tsai-Chung Li
- Graduate Institute of Biostatistics, China Medical University, Taichung, 404, Taiwan
| | - Mao-Feng Sun
- Department of Chinese Medicine, China Medical University Hospital, Taichung 404, Taiwan; School of Chinese Medicine, College of Chinese Medicine, China Medical University, Taichung 404, Taiwan
| | - Hen-Hong Chang
- Department of Chinese Medicine, China Medical University Hospital, Taichung 404, Taiwan; School of Chinese Medicine, College of Chinese Medicine, China Medical University, Taichung 404, Taiwan
| | - Fuu-Jen Tsai
- School of Chinese Medicine, College of Chinese Medicine, China Medical University, Taichung 404, Taiwan; Research Center for Chinese Medicine & Acupuncture, China Medical University, Taichung, 404, Taiwan
| | - Hung-Rong Yen
- Department of Chinese Medicine, China Medical University Hospital, Taichung 404, Taiwan; School of Chinese Medicine, College of Chinese Medicine, China Medical University, Taichung 404, Taiwan; Research Center for Chinese Medicine & Acupuncture, China Medical University, Taichung, 404, Taiwan; Research Center for Traditional Chinese Medicine, Department of Medical Research and Department of Chinese Medicine, China Medical University Hospital, Taichung 404, Taiwan.
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8
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Raymond J, Johnson ST, Diehl-Jones W, Vallance JK. Walking, Sedentary Time and Health-Related Quality Life Among Kidney Transplant Recipients: An Exploratory Study. Transplant Proc 2016; 48:59-64. [PMID: 26915844 DOI: 10.1016/j.transproceed.2015.12.022] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/08/2015] [Accepted: 12/22/2015] [Indexed: 12/01/2022]
Abstract
OBJECTIVES The primary objectives of this study were to: 1) establish walking and physical activity prevalence and sedentary time estimates; and 2) determine associations of health-related quality of life (HRQoL) with objectively assessed walking, self-reported physical activity, and sedentary time among kidney transplant recipients. METHODS Using a cross-sectional design, kidney transplant recipients received a survey package containing measures of sedentary time, moderate-to-vigorous physical activity, and HRQoL, and a step pedometer. RESULTS Thirty-two participants returned a completed survey, for a response rate of 82% (32 of 39 interested participants). The average steps per day were 9752 steps (SD = 3685) and 59% achieved public health guidelines of at least 150 minutes of moderate-to-vigorous physical activity per week. Total sedentary time during the week was 11.6 h/d whereas total sedentary time during the weekend was 8.9 h/d. Compared to those not achieving at least 10,000 steps/d, respondents who were achieving at least 10,000 steps/d had a significantly higher physical component score for HRQoL (Mdiff = 7.8, P = .018). Similar patterns emerged for meeting physical activity guidelines and sedentary time. CONCLUSION For kidney transplant recipients, greater participation in walking, overall physical activity, and lower engagement in sedentary activity, was associated with better HRQoL.
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Affiliation(s)
- J Raymond
- Faculty of Health Disciplines, Athabasca University, Athabasca, Canada
| | - S T Johnson
- Faculty of Health Disciplines, Athabasca University, Athabasca, Canada
| | - W Diehl-Jones
- Faculty of Health Disciplines, Athabasca University, Athabasca, Canada
| | - J K Vallance
- Faculty of Health Disciplines, Athabasca University, Athabasca, Canada.
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9
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Li YN, Shapiro B, Kim JC, Zhang M, Porszasz J, Bross R, Feroze U, Upreti R, Martin D, Kalantar-Zadeh K, Kopple JD. Association between quality of life and anxiety, depression, physical activity and physical performance in maintenance hemodialysis patients. Chronic Dis Transl Med 2016; 2:110-119. [PMID: 29063031 PMCID: PMC5643749 DOI: 10.1016/j.cdtm.2016.09.004] [Citation(s) in RCA: 27] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/10/2016] [Indexed: 01/08/2023] Open
Abstract
OBJECTIVE Maintenance hemodialysis (MHD) patients often have impaired quality of life (QOL), anxiety, depression, and reduced daily physical activity (DPA) and physical performance. The contributions of these latter factors to reduced QOL in MHD are poorly understood. We examined the association of QOL with anxiety, depression, DPA, and physical performance. METHODS Seventy-two relatively healthy adult MHD patients, vintage ≥6 months, and 39 normals of similar age range and gender distribution were studied. QOL was assessed using the Kidney Disease Quality of Life-Short Form (KDQOL-SF). Anxiety and depression were each evaluated with two questionnaires. DPA and physical performance were assessed with a physical activity monitor, Human Activity Profile, and 6-minute walk, sit-to-stand, and stair-climbing tests. RESULTS Most KDQOL components were reduced in MHD patients versus normals. KDQOL components in patients were commonly inversely correlated with measures of anxiety and depression (P < 0.05) and were more reduced in patients with both anxiety and depression. KDQOL was often impaired in patients with either anxiety or depression. However, most KDQOL scores did not differ between patients and normals without anxiety or depression. DPA, Human Activity Profile, and physical performance often correlated with KDQOL scores in adjusted models, but after further adjustment for anxiety and depression, DPA, Human Activity Profile, and physical performance correlated less frequently with KDQOL scores. This reduction in significant correlations after adjustment for anxiety and depression was particularly pronounced for the association between KDQOL and DPA. CONCLUSION In relatively healthy MHD patients, KDQOL scores are usually decreased in those with anxiety and/or depression but are usually normal in those without anxiety or depression. Lower DPA in MHD patients with reduced KDQOL scores often appears to be associated with anxiety and depression. The relationship between QOL and physical performance appears to be less influenced by anxiety and/or depression. These data suggest that treatment of anxiety and depression in MHD patients may improve their QOL, DPA, and possibly physical performance.
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Affiliation(s)
- Yi-Nan Li
- Division of Nephrology and Hypertension, Los Angeles Biomedical Research Institute at Harbor - UCLA Medical Center, Torrance, CA 90502, USA.,Department of Nephrology, The First Affiliated Hospital of Xiamen University, Xiamen, Fujian 361003, China
| | - Bryan Shapiro
- Division of Nephrology and Hypertension, Los Angeles Biomedical Research Institute at Harbor - UCLA Medical Center, Torrance, CA 90502, USA
| | - Jun Chul Kim
- Division of Nephrology and Hypertension, Los Angeles Biomedical Research Institute at Harbor - UCLA Medical Center, Torrance, CA 90502, USA.,Division of Nephrology, CHA Gumi Medical Center, CHA University, Kyungsangbuk-do 730728, South Korea
| | - Min Zhang
- Division of Nephrology and Hypertension, Los Angeles Biomedical Research Institute at Harbor - UCLA Medical Center, Torrance, CA 90502, USA.,Division of Nephrology, Tianjin Union Medical Center, Tianjin 300121, China
| | - Janos Porszasz
- Rehabilitation Clinical Trials Center, Division of Respiratory & Critical Care Physiology & Medicine, Los Angeles Biomedical Research Institute at Harbor - UCLA Medical Center, Torrance, CA 90502, USA
| | - Rachelle Bross
- UCLA Clinical and Translational Science Institute, Los Angeles Biomedical Research Institute at Harbor - UCLA Medical Center, Torrance, CA 90502, USA.,Harold Simmons Center for Kidney Disease Research and Epidemiology, Los Angeles Biomedical Research Institute at Harbor - UCLA Medical Center, Torrance, CA 90502, USA
| | - Usama Feroze
- George Washington University/Inova Fairfax Hospital Psychosomatic Fellowship Program, Washington, DC 20052, USA
| | - Rajeev Upreti
- Max Super Specialty Hospital, New Delhi, Delhi 110092, India
| | - David Martin
- Division of Psychology, Department of Psychiatry, Harbor - UCLA Medical Center, Torrance, CA 90502, USA
| | - Kamyar Kalantar-Zadeh
- Harold Simmons Center for Kidney Disease Research and Epidemiology, Los Angeles Biomedical Research Institute at Harbor - UCLA Medical Center, Torrance, CA 90502, USA.,Division of Nephrology and Hypertension, University of California at Irvine, Irvine, CA 92697, USA.,UCLA Fielding School of Public Health, Los Angeles, CA 90095, USA
| | - Joel David Kopple
- Division of Nephrology and Hypertension, Los Angeles Biomedical Research Institute at Harbor - UCLA Medical Center, Torrance, CA 90502, USA.,UCLA Fielding School of Public Health, Los Angeles, CA 90095, USA.,David Geffen School of Medicine at UCLA, Los Angeles, CA 90502, USA
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Hamada M, Yasuda Y, Kato S, Arafuka H, Goto M, Hayashi M, Kajita E, Maruyama S. The effectiveness and safety of modest exercise in Japanese patients with chronic kidney disease: a single-armed interventional study. Clin Exp Nephrol 2015. [PMID: 26209188 DOI: 10.1007/s10157-015-1147-6] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
Abstract
BACKGROUND Poor physical ability and skeletal muscle wasting are common in chronic kidney disease (CKD) patients, who may experience a decline in daily activity and, in turn, increased mortality. The purpose of this study was to evaluate the effectiveness and safety of modest exercise in patients with stable CKD. METHODS Forty-seven CKD patients were enrolled in a 6-month group program for aerobic and resistance exercise by self-training. Parameters of physical function and clinical laboratory markers, including renal function, were measured. RESULTS The International Physical Activity Questionnaire score improved from a baseline of 36.6 ± 13.8 to 40.1 ± 14.8 after the exercise program (P < 0.001). The number of daily steps increased from 6141 ± 2620 to 7679 ± 3026 (P < 0.001). We detected significant changes in the 30-s chair stand test (from 20.7 ± 5.3 to 26.0 ± 5.9 repetitions; P < 0.001), single-foot standing test (from 53.0 ± 44.3 to 68.4 ± 43.0 s; P = 0.001) and 6-min walk (from 501.6 ± 63.8 to 528.7 ± 71.8 m; P = 0.02). Moreover, body weight, waist circumference, and blood pressure were significantly reduced. No significant deterioration was observed in the estimated glomerular filtration rate. Proteinuria significantly decreased in 21 patients. CONCLUSION Our modest exercise program improved the physical performance of CKD patients without deterioration of renal function. These results suggest that exercise rather than excess rest should be recommended for CKD patients to avoid muscle wasting.
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Affiliation(s)
- Masami Hamada
- Department of Nursing, Nagoya University Graduate School of Medicine, Nagoya, Aichi, Japan
| | - Yoshinari Yasuda
- Department of CKD Initiatives, Nagoya University Graduate School of Medicine, Nagoya, Aichi, Japan
| | - Sawako Kato
- Department of Nephrology, Nagoya University Graduate School of Medicine, 65, Tsuruma-cho, Showa-ku, Nagoya, Aichi, 464-8550, Japan
| | - Hiroki Arafuka
- Department of Faculty of Social Welfare, Nihon Fukushi University, Mihama, Aichi, Japan
| | - Motomitsu Goto
- Department of Endocrinology and Diabetes, Nagoya University Graduate School of Medicine, Nagoya, Aichi, Japan
| | - Mutsuharu Hayashi
- Department of Cardiology, Banbuntane Hotokukai Hospital, Nagoya, Aichi, Japan
| | - Etsuko Kajita
- Department of Nursing, Nagoya University Graduate School of Medicine, Nagoya, Aichi, Japan
| | - Shoichi Maruyama
- Department of Nephrology, Nagoya University Graduate School of Medicine, 65, Tsuruma-cho, Showa-ku, Nagoya, Aichi, 464-8550, Japan.
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