Cardiorespiratory fitness and mortality risk in patients receiving hemodialysis: a prospective cohort.

Autor:	Andrade FP; Universidade Federal do Rio Grande do Sul, Ciências Pneumológicas Post-Graduation Program, Porto Alegre, RS, Brazil., Borba CF; Universidade Federal do Rio Grande do Sul, Escola de Fisioterapia, Porto Alegre, RS, Brazil., Ribeiro HS; Universidade de Brasília, Faculdade de Ciências da Saúde, Brasília, DF, Brazil., Rovedder PME; Universidade Federal do Rio Grande do Sul, Ciências Pneumológicas Post-Graduation Program, Porto Alegre, RS, Brazil.
Jazyk:	English; Portuguese
Zdroj:	Jornal brasileiro de nefrologia [J Bras Nefrol] 2024 Jan-Mar; Vol. 46 (1), pp. 39-46.
DOI:	10.1590/2175-8239-JBN-2022-0124en
Abstrakt:	Background: Kidney failure reduces life expectancy by one-third compared with the general population, and cardiovascular complications and poor cardiorespiratory fitness (CRF) are the main causes. We aimed to evaluate the association between severely low CRF and all-cause mortality risk in HD patients. Methods: This observational prospective cohort study followed-up patients receiving HD from August 2015 until March 2022. Cardiorespiratory fitness was evaluated through the cardiopulmonary exercise test, and the peak oxygen uptake (VO2peak) value was used to determine severely low CRF (< 15 mL∙kg-1∙min-1). Cox regression and univariate Kaplan-Meier analysis were used to evaluate the association of severely low CRF with mortality risk and survival rate. Results: Forty-eight patients were followed-up for a median of 33.0 [14.3 - 49.3] months. A total of 26 patients had severely low CRF. During the follow-up period, 11 patients (22.92%) died from all causes. From these, eight (30.8%) had severely low CRF. Even so, severely low CRF was not associated with crude death rates for patients stratified by CRF levels (p = 0.189), neither in unadjusted (HR 2.18; CI 95% 0.58-8.23) nor in adjusted (HR 1.32; CI 95% 0.31-5.59) Cox proportional hazard models. As a continuous variable, VO2peak was not associated with mortality risk (HR 1.01; CI 95% 0.84-1.21). Univariate Kaplan-Meier analysis showed that patients with severely low CRF did not have significantly worse survival rates than those with mild-moderate CRF (p = 0.186). Conclusion: Our findings indicated that severely low CRF was not associated with all-cause mortality in patients on HD. Despite severely low CRF being prevalent, larger cohort studies are needed to establish strong conclusions on its association with all-cause mortality.
Databáze:	MEDLINE
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