The association between medical fitness facility attendance and incident mental disorders.

Objective: This study examined the effects of medical fitness facility (MFF) attendance, a proxy for exercise, on the incidence of mental disorders.

Methods: This retrospective cohort study linked members at two MFFs in Winnipeg, Canada, to health administrative databases held at the Manitoba Centre for Health Policy population research data repository. Adults aged ≥ 18 years were assigned an index date at MFF membership enrollment between January 1, 2005, and December 31, 2015, and matched to controls based on propensity score weighting.

Risk of major adverse cardiovascular events in rural vs urban settings among patients with erectile dysfunction: a propensity-weighted retrospective cohort study of 430 621 men.

Background: The relationship between erectile dysfunction (ED) and cardiovascular (CV) events has been postulated, with ED being characterized as a potential harbinger of CV disease. Location of residence is another important consideration, as the impact of rural residence has been associated with worse health outcomes.

Aim: To investigate whether men from rural settings with ED are associated with a higher risk of major adverse CV events (MACEs).

A Randomized Trial Examining the Impact of Timing of Intradialytic Cycling on Intradialytic Hypotension.

Introduction: Intradialytic cycling is often performed during the first half of hemodialysis because of concerns regarding increased frequency of intradialytic hypotension (IDH) late in hemodialysis. This increases exercise program resource needs and limits utility of intradialytic cycling to treat dialysis-related symptoms.

Methods: This multicenter, randomized, crossover trial compared IDH rate when cycling during the first half versus the second half of hemodialysis in 98 adults on maintenance hemodialysis.

Change in Physical Activity and Function in Patients with Baseline Advanced Nondialysis CKD.

Background And Objectives: Although progressive decline in physical activity and function are common in individuals with worsening CKD, little is known about the effect of dialysis initiation on physical activity. We assessed for any association of progression to dialysis in people with advanced CKD with temporal rates of change in physical activity and function.

Design, Setting, Participants, & Measurements: Canadian Frailty Observation and Interventions Trial (CanFIT) participants with an eGFR of <30 ml/min per 1.

Association of Membership at a Medical Fitness Facility With Adverse Health Outcomes.

Introduction: Interventions that increase physical activity behavior can reduce morbidity and prolong life, but long-term effects in large populations are unproven. This study investigates the association of medical fitness facility membership and frequency of attendance with all-cause mortality and rate of hospitalization.

Methods: A propensity weighted retrospective cohort study was conducted by linking individuals who attended medical fitness facilities in Winnipeg, Canada to provincial health administrative databases.

Provider Perception of Frailty Is Associated with Dialysis Decision Making in Patients with Advanced CKD.

Background And Objectives: Frailty is common in patients with CKD. Little is known about the prevalence of frailty and its effect on prognosis and decisions surrounding dialysis modalities in patients with advanced CKD (eGFR<30 ml/min per 1.73 m).

Association of Physical Activity and Poor Health Outcomes in Patients With Advanced CKD.

Rationale & Objective: Chronic kidney disease (CKD) is associated with declining physical function and activity. In the general population, lower physical activity is associated with poorer quality of life and greater all-cause mortality. The aim of this study was to assess if lower physical activity levels are associated with adverse health outcomes in patients with advanced CKD.

The Impact of Frailty on Technique Failure and Mortality in Patients on Home Dialysis.

Patients on home dialysis therapies experience technique failure, which is associated with morbidity and mortality. Reasons for technique failure are complex, and often related to functional decline in the patient or caregiver. Frailty is associated with an increased risk of adverse health outcomes.

Intradialytic exercise preconditioning: an exploratory study on the effect on myocardial stunning.

Background: Exercise preconditioning provides immediate protection against cardiac ischemia in clinical/preclinical studies in subjects without chronic kidney disease. In individuals requiring renal replacement therapy, hemodialysis (HD) results in significant circulatory stress, causing acute ischemia with resultant recurrent and cumulative cardiac injury (myocardial stunning). Intradialytic exercise (IDE) has been utilized to improve functional status in individuals receiving HD.

Cognitive Impairment in Advanced Chronic Kidney Disease: The Canadian Frailty Observation and Interventions Trial.

Background: Chronic kidney disease (CKD) affects more than one third of older adults, and is a strong risk factor for vascular disease and cognitive impairment. Cognitive impairment can have detrimental effects on the quality of life through decreased treatment adherence and poor nutrition and results in increased costs of care and early mortality. Though widely studied in hemodialysis populations, little is known about cognitive impairment in patients with pre-dialysis CKD.

Frailty and physical function in chronic kidney disease: the CanFIT study.

Background: Frailty, a manifestation of unsuccessful aging, is highly prevalent in people with chronic kidney disease (CKD) and is associated with comorbid conditions in cross-sectional studies. Longitudinal studies investigating the progression of frailty in those with advanced non-dialysis CKD are lacking.

Objectives: Canadian Frailty Observation and Interventions Trial (CanFIT).

Urinary, Plasma, and Serum Biomarkers' Utility for Predicting Acute Kidney Injury Associated With Cardiac Surgery in Adults: A Meta-analysis.

Background: Early accurate detection of acute kidney injury (AKI) occurring after cardiac surgery may improve morbidity and mortality. Although several novel biomarkers have been developed for the early detection of AKI, their clinical utility in the critical intraoperative and immediate postoperative period remains unclear.

Study Design: Systematic review and meta-analysis.