Table 3 Summary of findings: association of PA and mortality outcomes

Tentori et al. (2010) [20]

HD

Age, sex, black (Y/N), ESRD duration, BMI, 14 comorbid conditions (Y/N)², albumin, phosphorus, calcium, creatinine, Hgb, catheter use (Y/N), smoker (Y/N), some college education (Y/N), employed (Y/N), private insurance (Y/N), lives alone (Y/N) and able to walk (Y/N)

All-cause mortality risk ↓ with ↑ PA (exercise frequency)

4143 (19.8)⁹

Reference: non-regular exercise (n = 10,999)

Regular exercise (≥ 1 time/wk) (n = 9921): 0.73 [0.69–0.78]

Reference: <1time/wk (n = 10,999)

1 time/wk (n = 2205): 0.82 [0.73–0.91]

2–3 times/wk (n = 3558): 0.72 [0.66–0.79]

4–5 times/wk (n = 1201): 0.73 [0.62–0.86]

6–7 times/wk (n = 2957): 0.69 [0.63–0.76]

Lopes et al. (2014) [21]

Region³, age, sex, black (Y/N), smoker (Y/N), employed (Y/N), some college education (Y/N), lives alone (Y/N), assistance with walking (Y/N), time on HD, strength/flexibility activities (Y/N), BMI, 14 comorbid conditions², catheter use (Y/N), Hgb, Kt/V, creatinine, albumin, calcium, systolic BP < 120mmHg (Y/N), systolic BP > 160mmHg (Y/N) phosphorus, PTH and nPCR

All-cause mortality risk ↓ with ↑PA

Never/rarely active: 427 (25.9)

Infrequently active: 93 (15.5)

Sometimes active: 143 (14.8)

Often active: 191 (13.9)

Very active: 119 (10.1)

Reference: never/rarely active (n = 1649)

Infrequently active (n = 599): 0.89 [0.72–1.10]

Sometimes active (n = 969): 0.84 [0.67–1.05]

Often active (n = 1373): 0.81 [0.68–0.96]

Very active (n = 1173): 0.60 [0.47–0.77]

Kutner et al. (2016) [22]

Age, sex, race (White, Black, other), college education (Y/N), current smoker (Y/N), participant clinic, BMI, diabetes (Y/N), CV comorbidity (Y/N)⁴, lupus/rheumatoid arthritis (Y/N), COPD (Y/N), cancer (Y/N), ESRD duration, catheter use (Y/N), hours wk/HD treatment

All-cause mortality risk ↓ in active patients

Inactive: 67 (18.4)

Active: 43 (11.0)

Reference: inactive (n = 364)

Active (n = 391): 0.61 [0.40–0.93]

Zhang et al. (2017) [23]

Age

All-cause mortality risk ↓ with ↑ light and overall PA

133 (42.0)⁹

Every hour/wk increase of light PA:

0.69 [0.49–0.98]

Every Kcal/kg/day increase of overall PA: 0.66 [0.45–0.95]

Matsuzawa et al. (2018) [24]

Age, sex, time on HD, BMI, diabetes (Y/N), peripheral vascular disease (Y/N), CBV accident/transient ischemic attack (Y/N), geriatric nutritional risk index, and comorbidity score

All-cause mortality risk ↓ with ↑steps/day

< 4000 steps/day: 61 (39.9)

≥ 4000 steps/day: 17 (13.0)

Reference: <4000 steps/day (n = 153)

≥ 4000 steps/day (n = 129): 0.42 [0.22–0.82]

Every increase of 1000 steps/day: 0.84 [0.74–0.96]

Johansen et al. (2019) [25]

Age, sex, race (Black, White, Asian, other), Hispanic (Y/N), BMI, time on HD, diabetes (Y/N), atherosclerotic heart disease (Y/N), heart failure (Y/N), catheter use (Y/N), albumin

All-cause mortality risk is related with all frailty components

All-cause mortality risk ↓ in active patients

204 (28.1)⁹

Reference: inactive (n = 297)

Active (n = 430): 0.70 [0.53–0.93]

Stack et al. (2005) [26]

HD + PD

Age, sex, race (White, Black, Asian), cause of ESRD (glomerulonephritis, diabetes, hypertension), congestive heart failure (Y/N), coronary artery disease (Y/N), peripheral vascular disease (Y/N), left ventricular hypertrophy (Y/N), undernourished (Y/N, caregiver subjective opinion), albumin, phosphorus and hematocrit

All-cause mortality risk ↓ for patients exercising 2–3 times/wk. No significant results for 4–5 times/wk and daily exercise.

No significant results for CV mortality.

1366 (57.3)⁹

Reference: ≤1time/wk (n = 1333)

2-3times/wk (n = 437): 0.74 [0.58–0.95]

4-5times/wk (n = 134): 0.70 [0.47–1.04]

Daily (n = 482): 1.06 [0.86–1.30]

2-3times/wk: 0.80 [0.58–1.08]¹

(Reference: ≤1time/wk)

Brar et al. 2019 [27]

Age, sex, albumin, hemoglobin and number of comorbidities

No significant reduction in all-cause mortality risk for active patients

38 (34.9)⁹

Reference: inactive

Active: 0.55 [0.27–1.13]

Zelle et al. (2011) [28]

KT

Age, sex, history of CV events⁵ (Y/N), insulin concentration, systolic BP, waist circumference, triglycerides, smoker (Y/N), CRP, Framingham risk score, creatinine clearance, urinary protein excretion, 24-h urinary creatinine

All-cause and CV mortality risk ↓ with ↑PA

81 (15.0)⁹

Every increase of 1 MET-min/day: 0.75 [0.60–0.94]

Every increase of 1 MET-min/day: 0.62 [0.45–0.86]

Rosas et al. (2012) [29]

Recipient and donor age, African American (Y/N), sex, diabetes (Y/N), dialysis duration, ever smoked (Y/N), BMI, delayed graft function⁶ (Y/N)

All-cause mortality risk ↓ with ↑PA at the time of kidney transplantation

Inactive: 61 (36.3)

Moderate: 39 (23.3)

Active: 28 (16.3)

Reference: inactive (n = 169)

Moderate (n = 166): 0.87 [0.56–1.35]

Active (n = 172): 0.52 [0.31–0.87]

Every 10-unit increase in PASE score: 0.96 [0.92–0.99]

Byambasukh et al. (2020) [19]

Age, sex, eGFR, urinary protein excretion, time between transplantation and baseline, primary renal disease⁷, acute rejection (Y/N), pre-emptive transplantation (Y/N), living donor (Y/N), current smoker (Y/N), total alcohol consumption, total energy intake, immunosuppressive medication (Y/N) ⁸, systolic BP, use of antihypertensive drugs (Y/N), triglycerides, HDL-C, BMI, waist circumference, 24-h creatinine excretion

All-cause and CV mortality risk ↓ with ↑PA

129 (19.8)⁹

Reference: inactive (n = 246)

Less active (n = 201): 0.45 [0.29–0.70]

Active (n = 203): 0.44 [0.28–0.69]

Less active: 0.55 [0.26–1.16]

Active: 0.44 [0.19–0.99]

(Reference: inactive)