A closer look at the trajectory of physical functioning in chronic hemodialysis

Ismay Van Loon, Marije E. Hamaker, Franciscus T.J. Boereboom, Muriel P.C. Grooteman, Peter J. Blankestijn, Rene M.A. Van Den Dorpel, Menso J. Nubé, Piet M. Ter Wee, Marianne C. Verhaar, Michiel L. Bots

Research output: Contribution to journalArticleProfessional

Abstract

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.

Original languageEnglish
Pages (from-to)594-599
Number of pages6
JournalAge and Ageing
Volume46
Issue number4
DOIs
Publication statusPublished - 1 Jul 2017

Cite this

Van Loon, I., Hamaker, M. E., Boereboom, F. T. J., Grooteman, M. P. C., Blankestijn, P. J., Van Den Dorpel, R. M. A., ... Bots, M. L. (2017). A closer look at the trajectory of physical functioning in chronic hemodialysis. Age and Ageing, 46(4), 594-599. https://doi.org/10.1093/ageing/afx006
Van Loon, Ismay ; Hamaker, Marije E. ; Boereboom, Franciscus T.J. ; Grooteman, Muriel P.C. ; Blankestijn, Peter J. ; Van Den Dorpel, Rene M.A. ; Nubé, Menso J. ; Ter Wee, Piet M. ; Verhaar, Marianne C. ; Bots, Michiel L. / A closer look at the trajectory of physical functioning in chronic hemodialysis. In: Age and Ageing. 2017 ; Vol. 46, No. 4. pp. 594-599.
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title = "A closer look at the trajectory of physical functioning in chronic hemodialysis",
abstract = "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.",
keywords = "Chronic kidney disease, Hemodialysis, Older people, Physical functioning, Quality of life",
author = "{Van Loon}, Ismay and Hamaker, {Marije E.} and Boereboom, {Franciscus T.J.} and Grooteman, {Muriel P.C.} and Blankestijn, {Peter J.} and {Van Den Dorpel}, {Rene M.A.} and Nub{\'e}, {Menso J.} and {Ter Wee}, {Piet M.} and Verhaar, {Marianne C.} and Bots, {Michiel L.}",
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Van Loon, I, Hamaker, ME, Boereboom, FTJ, Grooteman, MPC, Blankestijn, PJ, Van Den Dorpel, RMA, Nubé, MJ, Ter Wee, PM, Verhaar, MC & Bots, ML 2017, 'A closer look at the trajectory of physical functioning in chronic hemodialysis' Age and Ageing, vol. 46, no. 4, pp. 594-599. https://doi.org/10.1093/ageing/afx006

A closer look at the trajectory of physical functioning in chronic hemodialysis. / Van Loon, Ismay; Hamaker, Marije E.; Boereboom, Franciscus T.J.; Grooteman, Muriel P.C.; Blankestijn, Peter J.; Van Den Dorpel, Rene M.A.; Nubé, Menso J.; Ter Wee, Piet M.; Verhaar, Marianne C.; Bots, Michiel L.

In: Age and Ageing, Vol. 46, No. 4, 01.07.2017, p. 594-599.

Research output: Contribution to journalArticleProfessional

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

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DO - 10.1093/ageing/afx006

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Van Loon I, Hamaker ME, Boereboom FTJ, Grooteman MPC, Blankestijn PJ, Van Den Dorpel RMA et al. A closer look at the trajectory of physical functioning in chronic hemodialysis. Age and Ageing. 2017 Jul 1;46(4):594-599. https://doi.org/10.1093/ageing/afx006