Frequent Exercise May Improve Survival in Dialysis Patients

In patients with end-stage renal disease (ESRD), those who exercise 4- to 5- times per week have markedly improved survival compared with those who exercise less frequently or more frequently. Dr. Austin G. Stack, of Letterkenny General Hospital, Ireland, and colleagues examined the potential benefits of regular physical activity on mortality in 2386 ESRD patients in the Dialysis Morbidity and Mortality Wave 2 study.

Overall, 56% of subjects exercised less than once a week, 18% exercised 2-to 3-times per week, 6% exercised 4- to 5-times per week and 20% exercised daily. Severe limitations in vigorous physical activities were reported by 75% of patients, while 42% of subjects reported severe limitations in moderate physical activities.

After a mean follow-up of 3.6 years, there were 1366 deaths (57.3%) and 487 transplantations (20.4%).

"Multivariate modeling with adjustment for known mortality predictors confirmed the survival advantage of a 2- to 3-times per week or a 4- to 5-times per week exercise pattern (relative risks 0.74 and 0.70, respectively), whereas no such benefit was seen for those reporting daily exercise (adjusted RR, 1.06)," Dr. Stack’s team writes.

Patients with severe limitations in either moderate or vigorous physical activities had the greatest mortality risk. Subjects who exercised 2- to 3-times per week had a significantly lower RR for cardiovascular death (adjusted RR, 0.80).

Severe limitations in either moderate or vigorous physical activities were associated with significantly increased cardiovascular mortality.
Am J Kidney Dis 2005;45:690-701.

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