title: Six-minute walk test predicts all-cause mortality and technique failure in ambulatory peritoneal dialysis patients.
abstract: OBJECTIVE
  This study investigated the associated factors of 6-min walk test (6MWT) and its predictive value of outcome in patients undergoing peritoneal dialysis (PD).
  
  
  METHODS
  This is a single centre prospective observational cohort study. Stable ambulatory PD patients in our centre between 1 May 2010 and 30 April 2011 were enrolled in this study. All included subjects performed 6MWT, and 6-min walk distances (6MWDs) were recorded. Patients were divided into two groups according to 6MWD and prospectively followed up until death, cessation of PD or to the end of the study (30 September 2012).
  
  
  RESULTS
  A total of 145 patients were enrolled, including 63 (43%) males. Multiple stepwise regression showed that age (β = -0.295, P = 0.001), diastolic blood pressure (DBP) (β = 0.292, P = 0.001), left ventricular ejection fraction (LVEF) (β = 0.198, P = 0.019) were independently associated with lower 6MWD. By the end of the study, six (8%) patients died in long 6MWD group while 15 (20%) died in the short 6MWD group, a significantly lower patient survival was observed in short 6MWD group (Log-rank = 4.983, P = 0.026). Patients with short 6MWD also showed inferior technique survival (Log-rank = 4.838, P = 0.028). There was no significant difference in peritonitis-free survival between the two groups (Log-rank = 0.801, P = 0.371). However, more patients in short 6MWD group had been transferred to hemodialysis due to peritonitis (25% vs 4.2%, P = 0.013).
  
  
  CONCLUSIONS
  Age, diastolic blood pressure, LVEF are independent associated factors of 6MWD in patients undergoing PD. Having the advantages of easy applicability and safety, 6MWT may be proposed as an important predictor of outcome in ambulatory PD patients.
authors.affiliation: Renal Division, Renji Hospital, School of Medicine, Shanghai JiaoTong University, Shanghai Center for Peritoneal Dialysis, Shanghai, China.
authors.forename: Yuanyuan
authors.initials: Y
authors.lastname: Shi
authors.affiliation: Renal Division, Renji Hospital, School of Medicine, Shanghai JiaoTong University, Shanghai Center for Peritoneal Dialysis, Shanghai, China.
authors.forename: Dongxia
authors.initials: D
authors.lastname: Zheng
authors.affiliation: Renal Division, Renji Hospital, School of Medicine, Shanghai JiaoTong University, Shanghai Center for Peritoneal Dialysis, Shanghai, China.
authors.forename: Lin
authors.initials: L
authors.lastname: Zhang
authors.affiliation: Renal Division, Renji Hospital, School of Medicine, Shanghai JiaoTong University, Shanghai Center for Peritoneal Dialysis, Shanghai, China.
authors.forename: Zanzhe
authors.initials: Z
authors.lastname: Yu
authors.affiliation: Renal Division, Renji Hospital, School of Medicine, Shanghai JiaoTong University, Shanghai Center for Peritoneal Dialysis, Shanghai, China.
authors.forename: Hao
authors.initials: H
authors.lastname: Yan
authors.affiliation: Renal Division, Renji Hospital, School of Medicine, Shanghai JiaoTong University, Shanghai Center for Peritoneal Dialysis, Shanghai, China.
authors.forename: Zhaohui
authors.initials: Z
authors.lastname: Ni
authors.affiliation: Renal Division, Renji Hospital, School of Medicine, Shanghai JiaoTong University, Shanghai Center for Peritoneal Dialysis, Shanghai, China.
authors.forename: Jiaqi
authors.initials: J
authors.lastname: Qian
authors.affiliation: Renal Division, Renji Hospital, School of Medicine, Shanghai JiaoTong University, Shanghai Center for Peritoneal Dialysis, Shanghai, China.
authors.forename: Wei
authors.initials: W
authors.lastname: Fang
mesh_terms: D000328:Adult; D000367:Age Factors; D000368:Aged; D001794:Blood Pressure; D002681:China; D005080:Exercise Test / Q000379:methods*; D017079:Exercise Tolerance; D005260:Female; D006801:Humans; D053208:Kaplan-Meier Estimate; D007676:Kidney Failure, Chronic / Q000175:diagnosis / Q000401:mortality* / Q000503:physiopathology / Q000628:therapy*; D008297:Male; D008875:Middle Aged; D010531:Peritoneal Dialysis, Continuous Ambulatory / Q000009:adverse effects / Q000401:mortality*; D011237:Predictive Value of Tests; D011446:Prospective Studies; D018570:Risk Assessment; D012307:Risk Factors; D013318:Stroke Volume; D013997:Time Factors; D016896:Treatment Outcome; D016277:Ventricular Function, Left; D016138:Walking
keywords: patient survival; peritoneal dialysis; prognostic value; six-minute walk test; technique survival