Comparison of Body Composition, Physical Activity, and Physical Function in Patients After Coronary Artery Bypass Graft Surgery with and without Chronic Kidney Disease
Background and Purpose: It has been reported that cardiac disease and renal disease frequently coexisted. Recently, the term cardiorenal syndrome was used to describe the interaction between heart and kidney dysfunction. Chronic kidney disease (CKD) has become increasingly recognized as an independent risk factor of cardiovascular disease, and the cardiovascular disease is one of most severe complication in patients with CKD. Previous studies have showed the changes in body composition, physical inactivity, decreased physical function, and poor quality of life existed in patients with either cardiovascular disease or CKD. Patients concomitant with cardiovascular disease and kidney insufficiency were expected to significantly increase physical dysfunction. However, few studies addressed on these alterations in patients after coronary artery bypass grafting (CABG) with CKD were reported. The purposes of this study are: (1) to compare the body composition, physical activity, physical function, and quality of life between patients after CABG with and without CKD; and (2) to analyze the relationships among body composition, physical activity, and physical function in this population. It is expected that patients after CABG with CKD have the worse body composition, physical function, and quality of life than patients after CABG without CKD; and patients with higher physical activity levels have the better body composition, physical function, and quality of life.
Methods: All subjects were recruited from the clinics of a medical center. Thirty male patients after CABG with CKD and 30 matched controls were recruited (ages between 40-75 years old). All the subjects underwent dual-energy x-ray absorptiometry examination for body composition evaluation. Physical activity and quality of life were assessed by using long form of International Physical Activity Questionnaire and World Health Organization Quality of Life Instrument (WHOQOL)-brief. Physical function measurements included grip strength, 30-second chair stand test and six minutes walking test (6MWT). SPSS was used for all statistical analysis. Pair t-test or McNemar-Bowker were applied to examine the differences of all variables between two groups. Pearson’s and Spearman’s correlation coefficients and multiple regression analysis were used to examine the correlations among the measured variables. P values below 0.05 were considered statistically significant.
Results: The basic characteristics were similar between two groups. Patients after CABG with CKD exhibited lower lean mass in arms, and higher % fat mass in the legs as compared with those without CKD. Patients after CABG with CKD had lower 30-second chair stand test, and social relationships domain of quality if life than those without CKD, even after adjusting covariants. In addition, patients after CABG who had higher physical activity level had better physical function and quality of life.
Conclusion: Patients after CABG with CKD had worse body composition, physical function, and QOL than their counterparts. The post-CABG patients with higher physical activity levels have significantly better physical function and QOL.
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