Kidney Res Clin Pract > Volume 41(4); 2022 > Article |
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Characteristic | Exercise group | Control group | χ2 or t | p-value |
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Demographic characteristic | ||||
No. of patients | 18 | 21 | ||
Age (yr) | 57.61 ± 13.69 | 56.76 ± 12.32 | 0.20 | 0.84 |
Sex | ||||
Male | 10 (55.6) | 10 (47.6) | 0.24 | 0.62 |
Female | 8 (44.4) | 11 (52.4) | ||
Spouse | ||||
Yes | 17 (94.4) | 18 (85.7) | 0.80 | 0.61a |
No | 1 (5.6) | 3 (14.3) | ||
Educational level | ||||
≤High school | 10 (55.6) | 16 (76.2) | 1.86 | 0.17 |
≥College | 8 (44.4) | 5 (23.8) | ||
Job | ||||
Full time | 3 (16.7) | 3 (14.3) | 1.42 | 0.49 |
Part time | 3 (16.7) | 7 (33.3) | ||
None | 12 (66.7) | 11 (52.4) | ||
Religion | ||||
Yes | 14 (77.8) | 12 (57.1) | 1.86 | 0.31a |
No | 4 (22.2) | 9 (42.9) | ||
Health insurance | ||||
National | 15 (83.3) | 16 (76.2) | 0.30 | 0.70a |
Medicaid | 3 (16.7) | 5 (23.8) | ||
Monthly income ($) | ||||
<2,000 | 12 (66.7) | 18 (85.7) | 1.98 | 0.26a |
≥2,000 | 6 (33.3) | 3 (14.3) | ||
Dialysis-related characteristic | ||||
Hemodialysis vintage (yr) | 2.38 ± 2.72 | 5.74 ± 3.99 | –3.10 | 0.004 |
Dialysis duration/session (min) | 223.61 ± 17.81 | 228.10 ± 19.14 | 0.75 | 0.46 |
Blood flow rate (mL/min) | 281.67 ± 23.58 | 276.19 ± 24.39 | 0.71 | 0.48 |
Dialysate flow rate (mL/min) | 516.67 ± 70.71 | 571.43 ± 130.93 | 1.67 | 0.11 |
Dialyzer efficacy | ||||
High | 12 (66.7) | 17 (81.0) | 2.26 | 0.32a |
Medium | 5 (27.8) | 2 (9.5) | ||
Low | 1 (5.6) | 2 (9.5) | ||
Fistula type | ||||
Arteriovenous fistula | 16 (88.9) | 16 (76.2) | ||
Arteriovenous graft | 2 (11.1) | 5 (23.8) | 1.06 | 0.42a |
Clinical characteristic | ||||
Hemoglobin (g/dL) | 10.70 ± 1.18 | 10.25 ± 1.04 | –1.27 | 0.21 |
Albumin (g/dL) | 3.87 ± 0.18 | 3.77 ± 0.49 | –0.92 | 0.37 |
Calcium (mg/dL) | 8.65 ± 0.65 | 8.77 ± 0.67 | –0.58 | 0.57 |
Phosphorus (mg/dL) | 5.04 ± 1.32 | 4.81 ± 1.50 | 0.48 | 0.62 |
Potassium (mEq/L) | 5.10 ± 0.71 | 4.69 ± 0.68 | 1.80 | 0.08 |
Creatinine (mg/dL) | 10.09 ± 2.44 | 10.38 ± 2.21 | –0.38 | 0.71 |
Urea reduction ratio (%) | 74.78 ± 3.83 | 74.98 ± 4.00 | 0.16 | 0.88 |
Cause of renal failure | ||||
Diabetes | 7 (38.9) | 11 (52.4) | 0.82 | 0.70a |
Hypertension | 7 (38.9) | 6 (28.6) | ||
Others | 4 (22.2) | 4 (15.1) | ||
Charlson comorbidity index | 5.33 ± 2.35 | 5.14 ± 2.26 | 0.26 | 0.80 |
Dry body weight (kg) | 58.95 ± 10.30 | 56.57 ± 9.95 | 0.73 | 0.47 |
Variable |
Baseline |
In 12 wk |
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---|---|---|---|---|---|---|---|---|
Exercise group (n = 18) | Control group (n = 21) | χ2 or F | p-value | Exercise group (n = 18) | Control group (n = 21) | χ2 or F | p-value | |
Frailty (score) | ||||||||
Not frail, 0-2 | 10 (55.6) | 9 (42.9) | 0.63 | 0.53 | 18 (100) | 7 (33.3) | 18.72 | <0.001a |
Frail, 3-5 | 8 (44.4) | 12 (57.1) | 0 (0) | 14 (66.7) | ||||
Frailty phenotype | ||||||||
Gait speed (m/sec) | ||||||||
Not frail, ≥0.8 | 12 (66.7) | 11 (52.4) | 0.82 | 0.52 | 17 (94.4) | 7 (33.3) | 15.29 | <0.001a |
Frail, <0.8 | 6 (33.3) | 10 (47.6) | 1 (5.6) | 14 (66.7) | ||||
Grip strength (kg) | ||||||||
Not frail, M: ≥30 and F: ≥20 | 6 (33.3) | 12 (57.1) | 2.21 | 0.20 | 10 (55.6) | 7 (33.3) | 1.95 | 0.21 |
Frail, M: <30 and F: <20 | 12 (66.7) | 9 (42.9) | 8 (44.4) | 14 (66.7) | ||||
Physical activity | ||||||||
Not frail | 10 (55.6) | 7 (33.3) | 1.95 | 0.21 | 18 (100) | 7 (33.3) | 18.72 | <0.001a |
Frail | 8 (44.4) | 14 (66.7) | 0 (0) | 14 (66.7) | ||||
Exhaustion (vitality, score) | ||||||||
Not frail, ≥55 | 6 (33.3) | 5 (23.8) | 0.43 | 0.72a | 11 (61.1) | 2 (9.5) | 11.61 | 0.002a |
Frail, <55 | 12 (66.7) | 16 (76.2) | 7 (38.9) | 19 (90.5) | ||||
Weight loss, BMI (kg/m2) | ||||||||
Not frail, >18.5 | 16 (88.9) | 17 (81.0) | 0.47 | 0.67a | 17 (94.4) | 17 (81.0) | 1.58 | 0.35a |
Frail, ≤18.5 | 2 (11.1) | 4 (19.0) | 1 (5.6) | 4 (19.0) | ||||
SPPB (score) | ||||||||
Not frail, 10–12 | 14 (77.8) | 14 (66.7) | 0.59 | 0.497a | 18 (100) | 12 (57.1) | 10.03 | 0.002a |
Frail, <10 | 4 (22.2) | 7 (33.3) | 0 (0) | 9 (41.9) | ||||
Skeletal muscle mass (kg) | 25.46 ± 4.80 | 24.32 ± 4.16 | 0.15 | 0.71 | 25.47 ± 4.85 | 23.17 ± 4.71 | 0.79 | 0.37b |
Body fat (%) | 21.17 ± 7.85 | 22.21 ± 9.99 | 0.03 | 0.86 | 21.82 ± 7.84 | 24.11 ± 9.23 | 0.43 | 0.52b |
Lower leg muscles (kg) | 15.42 ± 3.70 | 14.16 ± 3.51 | 1.23 | 0.27 | 13.79 ± 3.10 | 12.51 ± 2.59 | 0.80 | 0.38b |
Variable | Time (wk) | Exercise group (n = 18) | Control group (n = 21) | F | p-value |
Repeated measures of ANCOVA |
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F | p-value | η₂ (f) | |||||||
Frailty (score)a | Baseline | 2.22 ± 1.22 | 2.52 ± 0.87 | 0.35 | 0.56 | Time | 1.80 | 0.17d | 0.048 |
4th | 1.33 ± 1.14c | 2.95 ± 1.02 | 17.52 | <0.001 | Group | 18.55 | <0.001 | 0.340 | |
8th | 1.11 ± 0.90c | 3.05 ± 1.02 | 26.47 | <0.001 | T*G | 21.74 | <0.001d | 0.376 (0.78) | |
12th | 0.94 ± 0.93c | 3.10 ± 1.04 | 34.71 | <0.001 | |||||
Gait speed (m/sec) | Baseline | 0.89 ± 0.22 | 0.83 ± 0.24 | 0.21 | 0.65 | Time | 8.18 | 0.003d | 0.185 |
4th | 1.14 ± 0.30c | 0.76 ± 0.22 | 11.88 | 0.001 | Group | 12.64 | 0.001 | 0.260 | |
8th | 1.18 ± 0.31c | 0.72 ± 0.19 | 20.23 | <0.001 | T*G | 32.2 | <0.001d | 0.464 (0.93) | |
12th | 1.21 ± 0.31c | 0.71 ± 0.19 | 24.26 | <0.001 | |||||
Grip strength (kg) | Baseline | 23.58 ± 9.79 | 26.10 ± 8.83 | 1.27 | 0.27 | Time | 1.92 | 0.15d | 0.051 |
4th | 24.00 ± 9.16 | 21.13 ± 9.51 | 0.18 | 0.68 | Group | 0.05 | 0.83 | 0.001 | |
8th | 25.28 ± 8.45 | 22.40 ± 9.78 | 0.52 | 0.48 | T*G | 9.73 | <0.001d | 0.213 (0.52) | |
12th | 25.61 ± 8.88 | 22.07 ± 8.41 | 0.75 | 0.39 | |||||
Exhaustion (vitality in SF-36, score) | Baseline | 48.46 ± 12.80 | 46.24 ± 10.79 | 1.27 | 0.27 | Time | 1.17 | 0.33 | 0.031 |
4th | 53.16 ± 12.06 | 44.11 ± 9.78 | 7.60 | 0.009 | Group | 9.96 | 0.003 | 0.217 | |
8th | 53.66 ± 8.99 | 41.68 ± 8.34 | 15.08 | <0.001 | T*G | 2.27 | 0.09 | 0.059 (0.25) | |
12th | 53.82 ± 10.06 | 43.26 ± 6.80 | 12.38 | 0.001 | |||||
Weight loss (BMI, kg/m2) | Baseline | 21.55 ± 2.31 | 21.68 ± 3.06 | 0.03 | 0.88 | Time | 3.35 | 0.05d | 0.085 |
4th | 21.53 ± 2.16 | 21.68 ± 3.02 | 0.03 | 0.86 | Group | 0.03 | 0.88 | 0.001 | |
8th | 21.53 ± 2.01 | 21.64 ± 2.77 | 0.04 | 0.84 | T*G | 1.67 | 0.20d | 0.044 (0.21) | |
12th | 21.58 ± 1.98 | 21.79 ± 3.01 | 0.24 | 0.63 | |||||
SPPB (score)b | Baseline | 10.67 ± 1.61 | 10.10 ± 2.02 | 0.07 | 0.79 | Time | 4.31 | 0.03d | 0.009 |
4th | 11.56 ± 0.98c | 9.52 ± 2.06 | 8.73 | 0.005 | Group | 8.73 | 0.006 | 0.142 | |
8th | 11.72 ± 0.67c | 9.86 ± 2.20 | 6.96 | 0.01 | T*G | 28.81 | <0.001d | 0.168 (0.45) | |
12th | 11.83 ± 0.51c | 9.76 ± 2.28 | 9.89 | 0.003 | |||||
Kt/V urea | Baseline | 1.64 ± 0.19 | 1.67 ± 0.19 | 0.14 | 0.71 | Time | 0.46 | 0.67d | 0.013 |
4th | 1.68 ± 0.24 | 1.71 ± 0.24 | 0.05 | 0.82 | Group | 0.29 | 0.59 | 0.008 | |
8th | 1.70 ± 0.23 | 1.71 ± 0.28 | 0.14 | 0.71 | T*G | 2.85 | 0.05d | 0.073 (0.28) | |
12th | 1.76 ± 0.30 | 1.64 ± 0.18 | 2.40 | 0.13 | |||||
Physical component summary | Baseline | 45.51 ± 6.48 | 44.50 ± 8.76 | 1.30 | 0.26 | Time | 5.59 | 0.003d | 0.134 |
4th | 49.41 ± 4.94 | 43.81 ± 7.38 | 8.35 | 0.007 | Group | 8.52 | 0.006 | 0.191 | |
8th | 50.31 ± 4.50 | 44.76 ± 6.88 | 7.41 | 0.01 | T*G | 1.98 | 0.13d | 0.052 (0.23) | |
12th | 51.80 ± 4.51 | 42.79 ± 8.38 | 10.95 | 0.002 | |||||
Mental component summary | Baseline | 50.35 ± 11.04 | 49.81 ± 9.17 | 0.12 | 0.73 | Time | 0.90 | 0.97 | 0.003 |
4th | 53.98 ± 7.83c | 45.22 ± 8.64 | 9.41 | 0.004 | Group | 5.11 | 0.03 | 0.124 | |
8th | 53.24 ± 7.28c | 44.95 ± 8.65 | 7.66 | 0.009 | T*G | 3.04 | 0.03 | 0.078 (0.29) | |
12th | 53.23 ± 8.60 | 48.95 ± 8.14 | 2.92 | 0.10 |
Data are expressed as mean ± standard deviation.
BMI, body mass index; Kt/V, K = dialyzer’s capacity to clear urea at the blood flow rate, t = treatment time, V = distribution volume of urea; SF-36, Short Form-36 tool; SPPB, short physical performance battery; T*G, time*group.
F is effect size calculated using the analysis of covariance (ANCOVA) model adjusted for dialysis vintage in G*Power (small = 0.10, medium = 0.25, large = 0.40); F-score calculated using ANCOVA adjusted by dialysis vintage (exercise group vs. control group).
Score range:
Variable |
Intention-to-treat analysis (n = 42) |
Per-protocol analysis (n = 39) |
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---|---|---|---|---|---|---|---|---|
Exercise group (n = 21) | Control group (n = 21) | zb | p-value | Exercise group (n = 18) | Control group (n = 21) | zb | p-value | |
Frailty score | –1.26 ± 0.96 | 0.57 ± 0.81 | –5.08 | <0.001 | –1.28 ± 1.02 | 0.57 ± 0.81 | –4.84 | <0.001 |
Slowness (gait speed, m/sec) | 0.27 ± 0.22 | –0.11 ± 0.15 | –4.77 | <0.001 | 0.31 ± 0.19 | –0.11 ± 0.15 | –5.21 | <0.001 |
Weakness (grip strength, kg) | 1.58 ± 3.94 | –4.02 ± 4.52 | –4.03 | <0.001 | 2.03 ± 3.79 | –4.02 ± 4.52 | –4.05 | <0.001 |
Exhaustion (vitality, score) | 4.57 ± 7.74 | –2.98 ± 9.91 | –2.30 | 0.02 | 5.36 ± 8.09 | –2.98 ±9.91 | –2.42 | 0.02 |
Weight loss (BMI, kg/m2) | 0.18 ± 1.20 | 0.48 ± 1.79 | –0.57 | 0.57 | 0.03 ± 1.07 | 0.48 ± 1.79 | 0.42 | 0.69 |
SPPB (0–12, score) | 0.88 ± 1.43 | –0.33 ± 1.68 | –2.06 | 0.04 | 1.17 ± 1.29 | –0.33 ± 1.68 | –2.67 | 0.01 |
Dialysis adequacy (Kt/V urea) | 0.13 ± 0.22 | –0.03 ± 0.13 | –2.48 | 0.01 | 0.12 ± 0.21 | –0.03 ± 0.13 | –2.48 | 0.01 |
QoL | ||||||||
PCS | 5.69 ± 5.58 | –1.72 ± 9.04 | –2.79 | 0.005 | 6.29 ± 5.62 | –1.72 ± 9.04 | –2.86 | 0.003 |
MCS | 2.49 ± 7.28 | –0.86 ± 9.41 | –1.59 | 0.11 | 2.88 ± 7.79 | –0.86 ± 9.41 | –1.54 | 0.13 |
Data are expressed as mean ± standard deviation.
BMI, body mass index; Kt/V, K = dialyzer’s capacity to clear urea at the blood flow rate, t = treatment time, V = distribution volume of urea; SPPB, short physical performance battery; MCS, mental component summary; PCS, physical component summary; QoL, quality of life.
Sunki Kim
https://orcid.org/0000-0001-5385-7604
Hye-Ja Park
https://orcid.org/0000-0002-8923-2611
Dong-Ho Yang
https://orcid.org/0000-0001-9404-0019