title: Habitual physical activity measured by accelerometer and survival in maintenance hemodialysis patients.
abstract: OBJECTIVE
  The association between mortality and physical activity based on self-report questionnaire in hemodialysis patients has been reported previously. However, because self-report is a subjective assessment, evaluating true physical activity is difficult. This study investigated the prognostic significance of habitual physical activity on 7-year survival in a cohort of clinically stable and adequately dialyzed patients.
  
  
  METHODS
  A total of 202 Japanese outpatients who were undergoing maintenance hemodialysis three times per week at the hemodialysis center of Sagami Junkanki Clinic (Japan) from October 2002 to February 2012 were followed for up to 7 years. Physical activity was evaluated using an accelerometer at study entry and is expressed as the amount of time a patient engaged in physical activity on nondialysis days. Cox proportional hazard regression was used to assess the contribution of habitual physical activity to all-cause mortality.
  
  
  RESULTS
  The median patient age was 64 (25th, 75th percentiles, 57, 72) years, 52.0% of the patients were women, and the median time on hemodialysis was 40.0 (25th, 75th percentiles, 16.8, 119.3) months at baseline. During a median follow-up of 45 months, 34 patients died. On multivariable analysis, the hazard ratio for all-cause mortality per 10 min/d increase in physical activity was 0.78 (95% confidence interval, 0.66-0.92; P=0.002).
  
  
  CONCLUSIONS
  Engaging in habitual physical activity among outpatients undergoing maintenance hemodialysis was associated with decreased mortality risk.
authors.affiliation: Department of Rehabilitation Sciences, Graduate School of Medical Sciences, Kitasato University, Sagamihara, Japan. ryota122560@gmail.com
authors.forename: Ryota
authors.initials: R
authors.lastname: Matsuzawa
authors.forename: Atsuhiko
authors.initials: A
authors.lastname: Matsunaga
authors.forename: Guoqin
authors.initials: G
authors.lastname: Wang
authors.forename: Toshiki
authors.initials: T
authors.lastname: Kutsuna
authors.forename: Akira
authors.initials: A
authors.lastname: Ishii
authors.forename: Yoshifumi
authors.initials: Y
authors.lastname: Abe
authors.forename: Yutaka
authors.initials: Y
authors.lastname: Takagi
authors.forename: Atsushi
authors.initials: A
authors.lastname: Yoshida
authors.forename: Naonobu
authors.initials: N
authors.lastname: Takahira
mesh_terms: D061725:Accelerometry; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D016001:Confidence Intervals; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D053208:Kaplan-Meier Estimate; D008297:Male; D008875:Middle Aged; D009043:Motor Activity; D015999:Multivariate Analysis; D016016:Proportional Hazards Models; D011446:Prospective Studies; D006435:Renal Dialysis; D051436:Renal Insufficiency, Chronic / Q000628:therapy*