Effect of Walkability on the Physical Activity of Hemodialysis Patients: a Multicenter Study

Introduction Physical activity is an important prognostic factor in patients undergoing hemodialysis. Walkability also affects physical activity. This study aimed to examine the effects of walkability on the physical activity of patients undergoing hemodialysis. Methods This multicenter study included 372 outpatients (69.1 ± 11.9 years, 229 males) undergoing hemodialysis at eight facilities in Japan. Patients were classified into two groups according to the walk score (WS) at home: WS ≥ 50 (walkable area group) and WS < 50 (car-dependent area group). The effects of WS on total physical activity, moderate-to-vigorous physical activity (MVPA), and walking that was assessed using the International Physical Activity Questionnaire (IPAQ) were examined. Results In the multivariate analysis, WS ≥ 50 was positively associated with walking ( β = 0.129, p = 0.013) and negatively associated with MVPA ( β = −0.102, p = 0.045). Subgroup analysis stratified by the age of 65 years showed similar results in both groups. Conclusions Walkability is associated with various intensities of physical activity in Japanese patients undergoing hemodialysis. Exercise management should take into account the characteristics of physical activity, depending on the residential area. Trial registration : UMIN, UMIN000050089. Registered 2023/01/20, https://center6.umin.ac.jp/cgi-open-bin/ctr/ctr_view.cgi?recptno=R000057060 .