Sedentary Behavior in Individuals With Diabetic Chronic Kidney Disease and Maintenance Hemodialysis

Objective: The objective of this study was to examine whether more advanced kidney failure is associated with sedentary behavior and whether demographics, comorbidity, nutritional, and inflammatory markers explain this association. Design: Observational study. Setting: Outpatients recruited from outpatient clinics and dialysis units. Subjects: One hundred sixty patients with chronic kidney disease (CKD) or receiving maintenance hemodialysis (MHD). Methods: Standardized questionnaires including Baecke physical activity questionnaire, standardized anthropometry examination, and blood draw. Main Outcome Measure: Sedentary behavior (defined as answering "very often'' for "during leisure time I watch television'' or answering "never'' for "during leisure time I walk'') and being physically active (top 25th percentile of the total Baecke score). Results: Nineteen percent of CKD and 50% ofMHD patients were sedentary (P<.001) and 38.8% of CKD and 11.3% ofMHD patients were physically active. In separate multivariable logistic regression models, compared with CKD patients, MHD patients were more sedentary (odds ratio 3.84; 95% confidence interval, 1.18-12.51) and less physically active (odds ratio 0.07; 95% confidence interval 0.01-0.40) independent of demographics, comorbidity, smoking, body size, serumhigh sensitivity C-reactiveprotein (hsCRP) and albumin. Congestive heart failure, peripheral vascular disease, and higher body mass index were independently associated with sedentary behavior, whereas younger age, lower body mass index, lower serum hsCRP, and higher serum albumin were associated with being physically active. Conclusions: Sedentary behavior is highly prevalent among diabetic CKD or MHD patients. The strong association of MHD status with sedentary behavior is not explained by demographics, smoking, comorbidity, nutritional, and inflammatory markers. Interventions targeting obesity might improve sedentary behavior and physical activity, whereas interventions targeting inflammation might improve physical activity in these populations. Published by Elsevier Inc. on behalf of the National Kidney Foundation, Inc.