ASSESSMENT OF PHYSICAL FUNCTIONING IN HEMODIALYSIS PATIENTS

7 Feb 2025 12 a.m. 12 a.m.
WCN25-AB-1010, Poster Board= FRI-370

Introduction:

Physical activity is crucial for the long-term prognosis of hemodialysis (HD) patients. There is a lack of real-world experience with methods for evaluating patients' ability to perform physical activity.

Methods:

In randomly selected 37 HD patients, who were no different from other 80 patients at the single dialysis center, a 6-minute walk test (6-MWT) was conducted along with a Physical Performance Battery tests.

Results:

Mean age was 59±18 years, dialysis duration – 61 (33-122) months; 62% male. The 6-MWT (371±100 m) in multiple regression analysis was linked to gender (+48±11 m in male; p<0,001), protein-energy wasting (PEW, -­29±12 m per each next grade; p=0,017), Kt/V (+10±3 m per 0,1; p=0,001), heart failure (-98±7 m per NYHA class; p<0,001), serum calcium (+10±3 m per 0,1 mmol/l). 

The safety was assessed by vital signs:

 

before 6-MWT

After

Mean difference

p

Heart rate

77 (67,5-94,5)

85 (73,5-98)

7±11

<0,001

systolic BP

120 (107,5-140)

130 (120-145)

5,5±12,8

0,013

diastolic BP

60 (60-70)

70 (60-70)

-3±10

0,076

respiratory rate

18 (18-22)

24 (20,5-27,5)

4,6±4,6

<0,001

pO₂

98 (97,5-99)

98 (97-99)

0 (0-1)

0,86

After 6-MWT individual Borg scale rating of perceived exertion median increased from 2 (2-3) to 3 (2-3); p=0,005. No adverse effects were detected.

The sit-to-stand test results (13±5 sec) in multiple regression analysis were linked to PEW (­-1,1±0,4 sec in final test score per each next PEW grade; p=0,008), heart failure (­-1,1±0,2 sec per NYHA class; p<0,001), Kt/V (+0,2±0,1 sec per 0,1 unit; p=0,011).

Other tests from Physical Performance Battery (balance, speed) were less sensitive in our population, and most patients showed submaximal scores.

There were no correlations between physical performance scales and KDQoL-36: either composite scales (physical or mental) or primary scales. Therefore, physical performance scales are an independent (of QoL parameters) surrogate outcomes in dialysis patients.

Conclusions:

The 6-minute walk test and the sit-stand test are simple and safe methods for assessing the physical functioning of hemodialysis patients. The rationality of their use among hemodialysis patients is confirmed by the relationship between test results and a number of modifiable treatment parameters, including dialysis adequacy.

I have no potential conflict of interest to disclose.

I did not use generative AI and AI-assisted technologies in the writing process.