Regular physical activity is not only associated with longevity in patients on hemodialysis, but more specifically reductions in cardiovascular mortality, according to new study findings.

Of 6147 European and Argentinian patients receiving hemodialysis in the DIET-HD study, 2940 (48%) reported no physical activity, 1981 (32%) occasional activity up to once a week, and 1226 (20%) frequent activity defined as twice a week or more. Physical activity was defined as participating in lifestyle activities such as work, household chores, travel, or leisure.

Over a median 3.8 years, 2337 patients (38%) died, including 1050 (45%) from cardiovascular causes. Cardiovascular causes comprised sudden death, acute myocardial infarction, pericarditis, atherosclerotic heart disease, cardiomyopathy, cardiac arrhythmia, cardiac arrest, valvular heart disease, pulmonary edema, and congestive heart failure.

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After propensity score weighting, occasional physical activity was significantly associated with a 20% lower risk for all-cause mortality, 18% lower risk for cardiovascular mortality, and 19% lower risk for noncardiovascular mortality in adjusted analyses compared with inactivity, Amelie Bernier-Jean, MD, PhD, of The Children’s Hospital at Westmead in New South Wales, Australia, and colleagues reported in Kidney International Reports. Frequent physical activity was significantly associated with an 18% lower risk for all-cause mortality and 23% lower risk for cardiovascular mortality, but not a lower risk for noncardiovascular mortality. As physical activity increased, the risk for cardiovascular mortality significantly decreased. Investigators adjusted results for patients’ diets.

“Our results indeed suggest that even low levels of physical activities that are likely to be safe may yield significant improvement in mortality,” Dr Bernier-Jean’s team concluded.

They encouraged future pragmatic randomized controlled trials of low-intensity physical activity for sedentary adults receiving hemodialysis.

Disclosure: Some study authors declared affiliations with biotech, pharmaceutical, and/or device companies. Please see the original reference for a full list of authors’ disclosures.


Bernier-Jean A, Wong G, Saglimbene V, et al. Self-reported physical activity and survival in adults treated with hemodialysis: a DIET-HD cohort study. Kidney Int Rep. doi:10.1016/j.ekir.2021.09.002