Kidney Week

Abstract: SA-PO449

Exercise Improves Self-Reported Physical Symptom Burden and Fatigue in Non-Dialysis CKD

Session Information

• CKD: Cognitive Dysfunction, Depression, Quality of Life
  November 04, 2017 | Location: Hall H, Morial Convention Center
  Abstract Time: 10:00 AM - 10:00 AM

Category: Chronic Kidney Disease (Non-Dialysis)

• 306 CKD: Cognitive Dysfunction, Depression, Quality of Life

Authors

• Wilkinson, Thomas James, University of Leicester, Leicester, United Kingdom

Thomas James Wilkinson,

• Xenophontos, Soteris, University of Leicester, Leicester, United Kingdom

Soteris Xenophontos,

• Gould, Douglas W., University of Leicester, Leicester, United Kingdom

Douglas W. Gould,

• Clarke, Amy L., University of Leicester, Leicester, United Kingdom

Amy L. Clarke,

• Vogt, Barbara Perez, Universidade Estadual Paulista UNESP , Botucatu, Brazil

Barbara Perez Vogt,

• Viana, Joao L., University Institute of Maia, Porto, Portugal

Joao L. Viana,

• Watson, Emma L., University of Leicester, Leicester, United Kingdom

Emma L. Watson,

• Smith, Alice C., John Walls Renal Unit, Leicester General Hospital, Leicester, United Kingdom

Alice C. Smith,

Background

CKD patients suffer from a variety of physical symptoms due to the disease and its treatments. Symptoms include fatigue, muscle weakness, pain, and sleep disruption, and these can negatively affect quality of life (QoL) and discourage physical activity. Whilst intradialytic exercise may help ameliorate some symptoms in dialysis patients, research on whether exercise can reduce symptom burden in non-dialysis patients is lacking.

Methods

36 patients (62±12 yrs; 22 female; eGFR: 26±8 mL/min/kg/1.73m²) completed supervised aerobic exercise (AE) (n=18) or combined aerobic plus resistance exercise (A+RE) (n=18) 3x/week for 12 weeks. Self-reported symptom burden and fatigue measures were taken pre- and post-exercise. The Leicester Uraemic Symptom Scale (LUSS) measured the frequency and intrusiveness of 11 symptoms. Fatigue was measured using the Functional Assessment of Chronic Illness Therapy-Fatigue Scale (FACIT-F); the total FACIT-F score and Trial Outcome Index (TOI) were used.

Results

AE reduced the total mean number of symptoms from 6.3 to 5.4 (14% P=.014) and the frequency of itching by 35% (P=.004). AE also reduced the intrusiveness of sleep disturbance by 14% (P=.001) and experience of muscle spasm/stiffness by 29% (P=.021). In the A+RE group, only a reduction in the frequency (41% P=.001) and intrusiveness (39% P<.001) of a feeling in loss of muscular strength/power was seen. Exercise improved fatigue; total FACIT-F score was improved in the AE and A+RE groups by 9% (P=.028) and 23% (P=.068) respectively, whilst the TOI was improved by 10% (P=.067) and 27% (P=.048).

Conclusion

Exercise can significantly reduce physical symptom burden and fatigue in non-dialysis CKD. Patients performing AE experienced less symptoms overall, with itching, sleep disturbance, and muscle stiffness symptoms improving specifically. Unsurprisingly, patients performing additional strength training felt stronger. Fatigue was improved following both exercise modalities. Symptom burden contributes to physical inactivity and a reduction in QoL, and as such exercise should be encouraged to help improve patient’s health status.

Funding

• Private Foundation Support