Physical Activity and Mortality in Adults Undergoing Hemodialysis: A DIET-HD Cohort Study
Bibliographic record
Abstract
Background: People receiving maintenance hemodialysis (MHD) are at higher risk of cardiovascular disease (CVD) and death. Regular exercise training reduces CVD mortality in people with coronary heart disease, but the potential survival benefits for adults undergoing MHD are unproven. We assessed the association between self-reported physical activity (PA) and mortality in a very large cohort of people receiving MHD. Methods: DIET-HD is a prospective, multinational study of adults undergoing MHD in Europe and South America. We classified participants as sedentary, exercises up to once a week (‘occasional PA’), or exercises twice a week or more (‘frequent PA’), using a selfreported question. We balanced the baseline characteristics, including socio-demographic factors, comorbidities, blood chemistry and dietary intake, across the PA groups using propensity scores. We conducted weighted Cox proportional hazards models with double robust estimators to assess the association between PA and mortality. Results: Of the 8043 participants initially included in the DIET-HD study, 6147 (76%) had information on PA. 1226 (20%) exercised frequently, 1981 (32%) occasionally and 2940 (48%) were sedentary. During a median follow-up of 3.82 years (19 677 personyears), 2337 (38%) deaths occurred, of which 1050 (45%) were from CVD causes. After propensity score-weighing and adjustment for potential confounders, PA was associated with a lower risk of all-cause mortality, CVD mortality and non-CVD mortality (Table). We observed a dose-dependent effect of PA for CVD death. Conclusions: Regular PA is associated with a lower risk of CVD mortality in adults receiving MHD. Until randomised control trials assess whether PA improves survival in MHD, it should be considered as part of the clinical management of MHD patients. Funding: Government Support - Non-U.S.
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How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.001 | 0.001 |
| Meta-epidemiology (narrow) | 0.000 | 0.001 |
| Meta-epidemiology (broad) | 0.001 | 0.001 |
| Bibliometrics | 0.001 | 0.002 |
| Science and technology studies | 0.001 | 0.000 |
| Scholarly communication | 0.001 | 0.001 |
| Open science | 0.001 | 0.001 |
| Research integrity | 0.001 | 0.001 |
| Insufficient payload (model declined to judge) | 0.001 | 0.000 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".