Supplementary Material for: Intradialytic Activities and Health-Related Quality of Life Among Hemodialysis Patients

<b><i>Background:</i></b> Health-related quality of life (HRQOL) reflects a patient’s perceived disease burden, treatment effectiveness, and health status. Given the time burden and physiologic effects of hemodialysis, patients who spend dialysis time (9–15 h/week) physically or intellectually engaged may have better HRQOL. We characterized the intradialytic activities and explored their association with HRQOL. <b><i>Methods:</i></b> In a cross-sectional study of 431 hemodialysis patients, we ascertained kidney-disease-specific quality of life, measured frailty, and surveyed participants about their usual active intradialytic activities (reading, playing games, doing puzzles, chatting, or other) and passive intradialytic activities (watching TV or sleeping). We used adjusted ordered logistic regression to identify correlates of the activity index (the sum of active intradialytic activities) and adjusted linear regression to quantify the association between the activity index and physical-, mental-, and kidney-disease-specific HRQOL. <b><i>Results:</i></b> The 2 most common intradialytic activities were passive activities (watching TV = 87.9%; sleeping = 72.4%). Participants who were female (aOR 1.85, 95% CI 1.28–2.66; <i>p</i> = 0.001), nonfrail (aOR 1.70, 95% CI 1.06–2.70; <i>p </i>= 0.03), and nonsmokers (aOR 2.61, 95% CI 1.39–4.90; <i>p</i> = 0.003) had a higher intradialytic activity index after adjustment. Higher intradialytic activity index was associated with better mental- (0.83 points, 95% CI 0.04–1.62; <i>p</i> = 0.04) and kidney-disease-specific HRQOL (1.70 points, 95% CI 0.47–2.93; <i>p</i> = 0.007), but not physical HRQOL. <b><i>Conclusions:</i></b> Hemodialysis patients with more active intradialytic activities report better mental and kidney-disease-specific HRQOL. These results should be confirmed in a prospective study with a broader cohort of hemodialysis patients. Dialysis providers may consider offering patients with low levels of activity additional support and opportunities to engage in beneficial intradialytic activities.

**<i>背景：</i>** 健康相关生活质量（Health-related quality of life, HRQOL）可反映患者感知的疾病负担、治疗效果及健康状态。鉴于血液透析存在时间负担与生理影响，每周需花费9~15小时进行透析的患者，若在透析期间参与体力或脑力活动，其健康相关生活质量可能更佳。本研究旨在描述透析中活动的特征，并探讨其与健康相关生活质量的关联。
**<i>方法：</i>** 本研究纳入431名血液透析患者开展横断面研究，我们评估了肾病特异性生活质量，测量了受试者的衰弱状态，并调查了其日常的主动透析中活动（阅读、玩游戏、解谜、聊天或其他活动）与被动透析中活动（看电视或睡觉）。我们采用校正后的有序logistic回归分析活动指数（主动透析中活动的总和）的相关影响因素，并通过校正后的线性回归量化活动指数与躯体、心理及肾病特异性健康相关生活质量之间的关联。
**<i>结果：</i>** 最常见的两种透析中活动为被动活动（看电视占比87.9%；睡觉占比72.4%）。校正混杂因素后，女性（调整后比值比aOR 1.85，95%置信区间CI 1.28~2.66；*p*=0.001）、非衰弱者（aOR 1.70，95%CI 1.06~2.70；*p*=0.03）及非吸烟者（aOR 2.61，95%CI 1.39~4.90；*p*=0.003）的透析中活动指数更高。更高的透析中活动指数与更佳的心理（0.83分，95%CI 0.04~1.62；*p*=0.04）及肾病特异性健康相关生活质量（1.70分，95%CI 0.47~2.93；*p*=0.007）相关，但与躯体健康相关生活质量无显著关联。
**<i>结论：</i>** 透析中活动更频繁的血液透析患者，其报告的心理及肾病特异性健康相关生活质量更佳。上述结论需在纳入更广泛血液透析患者队列的前瞻性研究中进一步验证。透析诊疗机构可考虑为活动水平较低的患者提供额外支持与参与有益透析中活动的机会。