Physical Activity Across the Clinical Trajectory of Chronic Kidney Disease and in Patients Undergoing Peritoneal...

Physical activity is associated with prognosis in older adults with chronic kidney disease (CKD). However, previous studies have relied mainly on self-report questionnaires, and objective evidence remains limited, particularly among patients undergoing peritoneal dialysis (PD). We assessed physical activity using a triaxial accelerometer across CKD stages and PD and examined its association with exercise self-efficacy.

This cross-sectional study included 114 outpatients recruited between June 2023 and June 2024. Physical activity was measured with a triaxial accelerometer over four consecutive days. Exercise self-efficacy was assessed using the Exercise Self-Efficacy Scale. Group differences and associations between physical activity and clinical variables were examined.

In total, 114 participants (early: n = 37; advanced: n = 47; PD: n = 30) were analyzed. Physical activity declined with disease progression and was lowest in the PD group. Median daily step counts were 4729, 3831, and 3086 in the early, advanced, and PD stages, respectively, with a significant difference between early-stage CKD and PD (p = 0.04). Median moderate-to-vigorous physical activity (min/week) was 75, 40, and 32.5, respectively, remaining below recommended levels in all groups. In the PD group, higher exercise self-efficacy was independently associated with greater moderate-to-vigorous physical activity and step counts.

Physical activity declined with CKD progression, reaching low levels among patients undergoing PD. In this group, exercise self-efficacy was associated with physical activity, suggesting its relevance when developing strategies to support activity. Further research should identify appropriate ways to encourage physical activity in aging CKD populations.