Acta Medica Okayama 80巻 1号
2026-02 発行

A Novel Nomogram that Predicts Chronic Hemodialysis Patients’ Survival Based on Their Sedentary Behavior

Sugahara, Kentaro Department of Hygiene, Faculty of Medicine, Kagawa University
Kondo, Takashi Innoshima General Hospital
Miyatake, Nobuyuki Department of Hygiene, Faculty of Medicine, Kagawa University
Nishi, Hiroyuki Innoshima General Hospital
Ujike, Kazuhiro Innoshima General Hospital
Koumoto, Kiichi Innoshima General Hospital
Namio, Keiichi Department of Hygiene, Faculty of Medicine, Kagawa University
Hishii, Shuhei Department of Hygiene, Faculty of Medicine, Kagawa University
Katayama, Akihiko Faculty of Social Studies, Shikokugakuin University
Suzuki, Hiromi Department of Hygiene, Faculty of Medicine, Kagawa University
Yamamoto, Yorimasa Innoshima General Hospital
Publication Date
2026-02
Abstract
Appropriate treatments for chronic hemodialysis patients are a public health challenge in Japan. Sedentary behavior appears to be closely associated with these patients’ survival. We thus sought to develop a nomogram that predicts survival based on the duration of chronic hemodialysis patients’ sedentary behavior. One hundred twenty-four patients under chronic hemodialysis (73 men, 51 women, age 71.7±11.1 years) were enrolled in this cohort study. The patients wore a triaxial accelerometer that measured both their sedentary behavior, i.e., total sedentary behavior (minutes) and their maximum sedentary bouts (min) on non-hemodialysis days. We obtained the Kaplan-Meier curve and used the log-rank test and a Cox proportional hazards model to evaluate the relationship between the patients’ sedentary behavior and their survival. We also used a Cox proportional hazards model to develop a nomogram for the patients’ 5-year survival rate. Forty-six patients died during the follow-up period. When we stratified the patients by the medians of total sedentary behavior and maximum sedentary bouts, we observed significant between-group differences. After adjustment for confounding factors in a Cox proportional hazards model, total sedentary behavior and maximum sedentary bouts were identified as critical survival factors, and we generated a nomogram using an index of sedentary behavior. Our analysis results demonstrated that sedentary behavior on non-dialysis days was closely associated with the survival of the chronic hemodialysis patients, suggesting that a decrease in sedentary behavior would prolong their survival. The nomogram developed herein based on sedentary behavior may be useful for predicting the outcomes of chronic hemodialysis patients.
Document Type
Original Article
Keywords
nomogram
chronic hemodialysis
sedentary behavior
Cox proportional hazards model
Kaplan- Meier curve
Link to PubMed
ISSN
0386-300X
NCID
AA00508441
JaLC DOI
DOI:
80_1_009.pdf 2.33 MB