title: Phenotypes influencing low physical activity in maintenance dialysis.
abstract: OBJECTIVE
  The "Pas à Pas" initiative aimed at evaluating the weekly physical activity (PA) and its determinants in a large cohort of dialysis patients.
  
  
  METHODS
  Physical inactivity is a risk factor for mortality in maintenance dialysis patients and is still poorly documented in this population.
  
  
  METHODS
  A prospective national epidemiological study was performed.
  
  
  METHODS
  A total of 1,163 patients on maintenance dialysis (hemodialysis and peritoneal dialysis) were included.
  
  
  METHODS
  PA was recorded during seven consecutive days using a pedometer to measure daily step numbers.
  
  
  RESULTS
  Median age was 63 years (Q1 51-Q3 75). Sixty-three percent were sedentary (<5000 steps/day) with a median of 3,688 steps/day (1,866-6,271)]. PA level was similar between hemodialysis patients and those on peritoneal dialysis (3,693 steps [1,896-6,307] vs. 3,320 [1,478-5,926], P = .33). In hemodialysis patients, PA was lower on dialysis days compared with nondialysis days (2,912 [1,439-5,232] vs. 4,054 [2,136-7,108], respectively, P < .01). PA gradually decreased with age, 57% being sedentary between 50 and 65 years and 83% of patients after 80 years. Beyond this age effect, we identified, for the first time, specific phenotypes of patients with lower PA, such as inflammation, cardiovascular disease, protein energy wasting, obesity, and diabetes. By contrast, previous kidney transplantation and a higher muscle mass were associated with higher PA.
  
  
  CONCLUSIONS
  Dialysis patients present a very low level of PA with high sedentary. Acting on patient's modifiable phenotypes may help to increase PA to improve morbidity, mortality, and quality of life.
authors.affiliation: Néphrologie, Hôpital E. Herriot, Lyon, France.
authors.forename: Marine
authors.initials: M
authors.lastname: Panaye
authors.affiliation: Hémodialyse, AURA Nord, Saint Ouen, France.
authors.forename: Anne
authors.initials: A
authors.lastname: Kolko-Labadens
authors.affiliation: AURAD Aquitaine, Gradignan, France.
authors.forename: Catherine
authors.initials: C
authors.lastname: Lasseur
authors.affiliation: Effi-Stat, Paris, France.
authors.forename: Jean-Louis
authors.initials: JL
authors.lastname: Paillasseur
authors.affiliation: AUB Santé, Brest, France.
authors.forename: Marie Paule
authors.initials: MP
authors.lastname: Guillodo
authors.affiliation: Amgen, Neuilly/Seine, France.
authors.forename: Martial
authors.initials: M
authors.lastname: Levannier
authors.affiliation: Néphrologie, CHUV, Lausanne, Switzerland.
authors.forename: Daniel
authors.initials: D
authors.lastname: Teta
authors.affiliation: Néphrologie, CHLS, Carmen-Cens-Université de Lyon, Pierre Bénite, France. Electronic address: denis.fouque@chu-lyon.fr.
authors.forename: Denis
authors.initials: D
authors.lastname: Fouque
mesh_terms: D000368:Aged; D015992:Body Mass Index; D002318:Cardiovascular Diseases / Q000453:epidemiology; D016000:Cluster Analysis; D015897:Comorbidity; D003920:Diabetes Mellitus / Q000453:epidemiology; D005260:Female; D006801:Humans; D007249:Inflammation / Q000453:epidemiology; D016030:Kidney Transplantation; D008297:Male; D008875:Middle Aged; D009043:Motor Activity; D009752:Nutritional Status; D009765:Obesity / Q000453:epidemiology; D010530:Peritoneal Dialysis / Q000401:mortality*; D010641:Phenotype; D011446:Prospective Studies; D011502:Protein-Energy Malnutrition / Q000453:epidemiology; D011788:Quality of Life; D006435:Renal Dialysis / Q000401:mortality*; D057185:Sedentary Behavior