# Change trajectory of fluid load management behavior ability in peritoneal dialysis patients and its association with physical activity

## TL;DR

The study tracks how peritoneal dialysis patients manage fluid over time and finds that physical activity levels vary with different management patterns.

## Contribution

Identifies distinct fluid management trajectories in PD patients and links them to changes in physical activity over time.

## Key findings

- Three distinct fluid management trajectories were identified in PD patients.
- Physical activity scores increased over the first six months of dialysis across all groups.
- Group C2 showed higher physical activity scores than other groups at multiple stages.

## Abstract

This study aims to explore the change trajectory of fluid load management ability in peritoneal dialysis (PD) patients and the correlation between different trajectories and physical activity.

A total of 243 patients who underwent peritoneal dialysis were selected. A longitudinal investigation was carried out using the Peritoneal Dialysis Patient Volume Management Behavior Scale and the International Physical Activity Questionnaire-Long Form (IPAQ-LF).

Three trajectories of volume overload management behavioral ability were identified, namely C1 (low-level increasing group), C2 (medium-level increasing group), and C3 (low- to medium-level fluctuation group). There were significant differences between these categories in cultural-level trials (χ2 = 15.344, p = 0.018), diabetic nephropathy (χ2 = 11.267, p = 0.004), peritonitis during the study period (χ2 = 11.340, p = 0.003), and hypoalbuminemia (χ2 = 7.700, p = 0.021). During the first 6 months of initial peritoneal dialysis (T1–T4), each patient’s physical activity score increased [C1: (F = 107.250, p < 0.001); C2: (F = 45.383, p < 0.001); C3: (F = 30.194, p < 0.001)]. At the T1 stage, the physical activity score of group C2 was significantly higher than those of groups C1 and C3 (p < 0.01). At the T2 stage, the physical activity score of group C2 was significantly higher than that of group C3 (p < 0.001), and the physical activity score of group C1 was significantly higher than that of group C3 (p < 0.01). At the T3–T4 stage, the score of group C1 was significantly higher than that of groups C2 and C3 (p < 0.01), and the score of group C2 was significantly higher than that of group C3 (p < 0.001).

Education level, diabetic nephropathy, concurrent peritonitis, and hypoproteinemia affect the change trajectory of volume load. Additionally, volume overload management at different stages influences the physical activity of patients.