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Kidney Week

Abstract: TH-PO622

A Multicenter Exercise Intervention for Persons Transitioning to Dialysis Using the "Exercise Is Medicine" Framework

Session Information

Category: Health Maintenance, Nutrition, and Metabolism

  • 1300 Health Maintenance, Nutrition, and Metabolism


  • Ziolkowski, Susan, Stanford University School of Medicine, Palo Alto, California, United States
  • Bootwala, Ahad Amin, Emory University, Skokie, Illinois, United States
  • Jagannathan, Ram, Emory School of Medicine, Atlanta, Georgia, United States
  • Anand, Shuchi, Stanford University, Stanford, California, United States
  • Lobelo, Felipe, Emory University School of Public Health, Atlanta, Georgia, United States

Physical activity is associated with improvement of cardiovascular health, physical function, transplant outcomes and survival in persons with CKD. Yet at the time of dialysis initiation, 44% of individuals cannot walk one block and 56% cannot climb 12 stairs.


We are conducting a pilot and feasibility randomized controlled trial (NCT03311763) using the American College of Sports Medicine ‘Exercise is Medicine’ framework in patients with eGFR < 45 ml/min/1.73m2 not on dialysis, in racially and ethnically diverse regions (San Jose, CA and Atlanta, GA). Group 1 receives a wearable activity tracker and exercise counseling; Group 2 additionally receives 8 weeks of twice-weekly group exercise sessions from a fitness professional trained in CKD related concerns (high/ low blood pressure and glucose, dialysis access precautions). Physical activity questionnaires (i.e. SF-12, IPAQ) and measurements [6-minute walk test (6MWT), handgrip strength, anthropometrics] are obtained at baseline, 8 and 16 weeks. Fitness trackers record daily step totals.


51 patients were recruited (23 San Jose, 28 Atlanta). 82% of participants were non-white, 55% have diabetes and mean baseline eGFR was 30.9 ± 9.7. 6MWT means were 399 ± 118m (Group 1) and 433 ± 118m (Group 2), compared with 571 ± 90m previously reported in pooled analyses of healthy individuals. 7 individuals were hospitalized and 3 transitioned to dialysis during the study. Complete data will be available Fall 2019.


We successfully integrated recruitment, physical activity assessment and group exercise into diverse clinical settings servicing minority patients with advanced CKD. At baseline patients have poor capacity and experience a high burden of hospitalizations.

Participant Characteristics at Baseline
 Group 1 (n= 27)Group 2 (n=24)
Age61 (37-74)58 (32-72)
Hispanic Ethnicity1513


eGFR (ml/min/1.73m2)30 (7-46)33 (15-46)
BMI (kg/m2)31 (16-54)32 (17-45)
6MWT (m)383 (193-574)451 (193-719)
Handgrip strength (kg)24 (9-54)25 (11-55)

Data presented as Median (range) and %


  • NIDDK Support