TY - JOUR
T1 - A closer look at the trajectory of physical functioning in chronic hemodialysis
AU - Van Loon, Ismay
AU - Hamaker, Marije E.
AU - Boereboom, Franciscus T.J.
AU - Grooteman, Muriel P.C.
AU - Blankestijn, Peter J.
AU - Van Den Dorpel, Rene M.A.
AU - Nubé, Menso J.
AU - Ter Wee, Piet M.
AU - Verhaar, Marianne C.
AU - Bots, Michiel L.
PY - 2017/7/1
Y1 - 2017/7/1
N2 - Background: in chronic hemodialysis, physical functioning (PF) is known to be poor. We set out to assess to what extent chronic dialysis patients are able to maintain a good physical condition over time and what the influence of age is on the trajectory of PF.Methods: we used data form 714 prevalent hemodialysis patients, enrolled in the CONvective TRAnsport STudy (CONTRAST). The PF subscale of the KDQOL SF-36 was assessed at baseline (n = 679) and during 2 years of follow-up (n = 298). Baseline PF score (0-100) was categorized into tertiles (good, intermediate and low). Change of PF of ≥ 5 points was considered clinically relevant. A regression model was applied to assess factors related to 'decline of PF (≥5 points)/low PF (0-33) at follow-up'.Results: during follow-up, only 15.3 % (1 out of 6) of patients succeeded in maintaining a good physical condition, the remainder deteriorated or died. Of the older patients (≥75) only 3.6% remained in a good physical condition. Factors related to decline/low PF were increasing age (odds ratio [OR] = 1.96 [95% CI: 1.03-3.72] for 65-74 years and OR = 2.38 [95%CI: 1.17-4.84] for ≥75 years compared to <65 years) and albumin (OR = 1.10 [95%CI: 1.01-1.18] per g/L decrease).Conclusion: very few hemodialysis patients maintain a good physical condition over a 2-year time span. Especially in older patients, physical performance is poor and decline is faster than in the healthy population.These findings should be taken into account when considering dialysis in older patients and more emphasis should be placed to attempts for improving physical condition.
AB - Background: in chronic hemodialysis, physical functioning (PF) is known to be poor. We set out to assess to what extent chronic dialysis patients are able to maintain a good physical condition over time and what the influence of age is on the trajectory of PF.Methods: we used data form 714 prevalent hemodialysis patients, enrolled in the CONvective TRAnsport STudy (CONTRAST). The PF subscale of the KDQOL SF-36 was assessed at baseline (n = 679) and during 2 years of follow-up (n = 298). Baseline PF score (0-100) was categorized into tertiles (good, intermediate and low). Change of PF of ≥ 5 points was considered clinically relevant. A regression model was applied to assess factors related to 'decline of PF (≥5 points)/low PF (0-33) at follow-up'.Results: during follow-up, only 15.3 % (1 out of 6) of patients succeeded in maintaining a good physical condition, the remainder deteriorated or died. Of the older patients (≥75) only 3.6% remained in a good physical condition. Factors related to decline/low PF were increasing age (odds ratio [OR] = 1.96 [95% CI: 1.03-3.72] for 65-74 years and OR = 2.38 [95%CI: 1.17-4.84] for ≥75 years compared to <65 years) and albumin (OR = 1.10 [95%CI: 1.01-1.18] per g/L decrease).Conclusion: very few hemodialysis patients maintain a good physical condition over a 2-year time span. Especially in older patients, physical performance is poor and decline is faster than in the healthy population.These findings should be taken into account when considering dialysis in older patients and more emphasis should be placed to attempts for improving physical condition.
KW - Chronic kidney disease
KW - Hemodialysis
KW - Older people
KW - Physical functioning
KW - Quality of life
UR - http://www.scopus.com/inward/record.url?scp=85021714425&partnerID=8YFLogxK
U2 - https://doi.org/10.1093/ageing/afx006
DO - https://doi.org/10.1093/ageing/afx006
M3 - Article
C2 - 28164208
SN - 0002-0729
VL - 46
SP - 594
EP - 599
JO - Age and ageing
JF - Age and ageing
IS - 4
ER -