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Abstract: SA-OR065

Effect of a Pedometer-Based Intervention on Body Composition in ESRD

Session Information

  • Hemodialysis Potpourri
    November 09, 2019 | Location: 144, Walter E. Washington Convention Center
    Abstract Time: 05:54 PM - 06:06 PM

Category: Dialysis

  • 701 Dialysis: Hemodialysis and Frequent Dialysis

Authors

  • Sheshadri, Anoop, University of San Francisco, California, San Francisco, California, United States
  • Kittiskulnam, Piyawan, Chulalongkorn university, Bangkok, Thailand
  • Lai, Jennifer C., University of California, San Francisco, San Francisco, California, United States
  • Johansen, Kirsten L., Hennepin Healthcare, Minneapolis, Minnesota, United States
Background

A randomized trial of a pedometer-based intervention with weekly activity goals led to a modest increase in step count among dialysis patients. However, the effect of this intervention on body composition parameters has not been determined.

Methods

60 dialysis patients were randomized to standard care or a 3-month intervention program with pedometers and weekly step count targets. We obtained bioelectrical impedance spectroscopy (BIS) data on 54 of these patients (28 control, 26 intervention) at baseline, at 3 months, and 6 months and used linear mixed modeling (adjusted for sex and dialysis modality) to estimate differences in change in total-body muscle mass (TBMM) adjusted for height2, fat mass (kg), and body mass index (BMI) (kg/m2) between control and intervention groups.

Results

At baseline, there was no significant difference between groups in age, BMI, race, or body composition. There was no statistically significant difference in change between groups in muscle mass, fat mass, or BMI at 3 months. However, at 6 months, participants in the intervention had a significantly greater increase in TBMM of 0.4 kg/m2 (95% CI 0.02, 0.09) (Figure 1), decrease in fat mass (-4.5 kg [95% CI -8.5, -0.49]) and decrease in BMI (-0.8 kg/m2 [95% CI -1.7, -0.01]) relative to controls. Each increase of 1,000 steps from 0 to 3 months was associated with a 0.4 kg decrease in fat mass (95% CI 0.03, 0.7) but there was no dose-response relationship with TBMM/ht2 or BMI.

Conclusion

Patients assigned to a pedometer-based intervention lost weight compared with patients who did not engage in the intervention. Weight loss was driven primarily by changes in fat mass with relative preservation of muscle mass. The between-group differences appear to reflect a combination of negative changes in the control group as well as decrease of fat mass and increase of muscle mass in the intervention group. Achieved changes in step counts were correlated with changes in fat mass. These data support the use of our intervention in improving body composition measures in this population.

Funding

  • NIDDK Support