Kidney Week

Abstract: FR-PO536

Profiles of Physical Activity in Hemodialysis Patients Randomized into the HDFIT Trial

Session Information

• Physical Activity, Body Composition, Metabolism: Clinical
  October 26, 2018 | Location: Exhibit Hall, San Diego Convention Center
  Abstract Time: 10:00 AM - 12:00 PM

Category: Health Maintenance, Nutrition, and Metabolism

• 1302 Health Maintenance, Nutrition, and Metabolism: Clinical

Authors

• Larkin, John W., Pontifícia Universidade Católica do Paraná, Curitiba, Paraná, Brazil

John W. Larkin,

• Gonçalves, Priscila Bezerra, Pontifícia Universidade Católica do Paraná, Curitiba, Paraná, Brazil

Priscila Bezerra Gonçalves,

• Han, Hao, Fresenius Medical Care North America, Waltham, Massachusetts, United States

Hao Han,

• Raimann, Jochen G., Renal Research Institute, New York, New York, United States

Jochen G. Raimann,

• Han, Maggie, Renal Research Institute, New York, New York, United States

Maggie Han,

• Poli de Figueiredo, Carlos Eduardo, Pontifícia Universidade Católica do Rio Grande do Sul, Porto Alegre, Rio Grande do Sul, Brazil

Carlos Eduardo Poli de Figueiredo,

• Cuvello neto, Americo Lourenço, Hospital Alemão Oswaldo Cruz, Sao Paulo, Brazil

Americo Lourenço Cuvello neto,

• Barra, Ana Beatriz Lesqueves, Fresenius Medical Care, Rio de Janeiro, Brazil

Ana Beatriz Lesqueves Barra,

• Usvyat, Len A., Fresenius Medical Care North America, Waltham, Massachusetts, United States

Len A. Usvyat,

• Kotanko, Peter, Renal Research Institute, New York, New York, United States

Peter Kotanko,

• Canziani, Maria Eugenia F., Universidade Federal de São Paulo, Sao Paulo, Brazil

Maria Eugenia F. Canziani,

• Pecoits-Filho, Roberto, Pontifícia Universidade Católica do Paraná, Curitiba, Paraná, Brazil

Roberto Pecoits-Filho,

Group or Team Name

• HDFIT Study Investigators

Background

Profiles of physical activity (PA) are poorly understood in dialysis patients. We characterized granular profiles of PA in hemodialysis (HD) patients.

Methods

PA was measured with the Actigraph (www.actigraphcorp.com) monitor over 1 week in patients treated with high-flux HD during the baseline period of the HDFIT randomized controlled study, which is a 6-month study of the impacts of modality (HDF vs HD) on PA levels (ClinicalTrials.gov: NCT02787161). Granular PA levels were captured in blocks including a HD period (Block A), 2-hour (hr) post-HD period (Block B; includes 30min data slices), and 2-to-24hr post-HD period (Block C; includes 4.5hr data slices) captured over 24hr periods relative to the start time of HD on dialysis days, and concurrent periods on non-HD days and the long interdialytic day.

Results

We recruited 195 HD patients from 13 sites during October 2016 to 2017. Patients were: age 53±15 years, 71% male, 59% white race, post-HD weight 76±16 Kg, 29% with diabetic nephropathy, 26% with hypertensive nephrosclerosis, and 16% with chronic glomerulonephritis. Patients took a mean of 4,725 steps/24hrs. On non-HD days and the long interdialytic day, patients took 1,387 and 1,105 more steps/24hrs vs HD days respectively (both p<0.001). During concurrent times to the HD session on non-HD days and the long interdialytic day, patients performed 1,351 and 1,082 more steps respectively (both p<0.001). Surprisingly, on HD days patients performed more steps in each 30 min slice during the 2hr post-HD period vs concurrent times on non-HD days and the long interdialytic day (all p<0.05). On non-HD days, patients performed more steps during the 2 to 6.5hr post-HD period (p<0.05).

Conclusion

Findings revel PA levels tend to be lower on HD days primarily due to sitting/lying during HD treatments, albeit patients had higher post-HD PA levels compared to concurrent times on non-HD days that may be related to transportation from the clinic. Offering intradialytic exercise programs could help increase PA during HD, potentially above sedentary levels (i.e. >5,000 steps/day or equivalents) with potential benefits as observed in the general population.

Funding

• Commercial Support