Exercise Parameters Predict Technique Survival in Patients on Peritoneal Dialysis

Takashin Nakayama, Kiyotaka Uchiyama, Naoki Washida, Kohkichi Morimoto, Kaori Muraoka, Keika Adachi, Takahiro Kasai, Kazutoshi Miyashita, Shu Wakino, Hiroshi Itoh

Research output: Contribution to journalArticlepeer-review

Abstract

Objective: The incremental shuttle walking test (ISWT) is an important marker of aerobic capacity in patients on peritoneal dialysis (PD). This study aimed to evaluate its predictive value for PD-related outcomes. Methods: This single-center cohort study recruited outpatients on maintenance PD from our hospital between March 2017 and March 2018. Exercise capacity was assessed using measurement of ISWT and handgrip and quadriceps strength. Patients were divided into 2 groups according to the median of exercise capacity and prospectively followed up until cessation of PD, death, or the study end (October 2019). The primary end point of this study was technique survival rate, and secondary outcomes were rates of peritonitis-free survival and PD-related hospitalization-free survival. Results: Among the 50 participants, age and PD vintage were [median (IQR)] 62.5 (58.3-70) and 3.5 (1.3-6.5) years, respectively. At the end of the study, 3 of the 28 participants (11%) in the long-ISWT group and 13 of the 22 participants (59%) in the short-ISWT group were transferred to hemodialysis. The short-ISWT group showed lower technique survival rate (p < 0.001), peritonitis-free survival rate (p = 0.01), and PD-related hospitalization-free survival rate (p < 0.01) than the long-ISWT group, whereas those survival rates did not differ when participants were divided by handgrip or quadriceps strength. Multivariate analysis revealed lower ISWT to be independently associated with technique failure (p = 0.002). Conclusion: The ISWT is an important predictor of technique survival for patients on PD. Monitoring and enhancing ISWT as a marker of aerobic capacity might improve PD-related outcomes.

Original languageEnglish
JournalBlood Purification
DOIs
Publication statusAccepted/In press - 2020

Keywords

  • Aerobic capacity
  • Assisted peritoneal dialysis
  • Exercise capacity
  • Frailty
  • Incremental shuttle walking test
  • Peritoneal dialysis-related outcome

ASJC Scopus subject areas

  • Hematology
  • Nephrology

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