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Kidney Week

Abstract: TH-PO283

Physical Activity Levels In Hemodialysis Patients: The Fitbit Prospective Study

Session Information

Category: Dialysis

  • 701 Dialysis: Hemodialysis and Frequent Dialysis


  • Kumar, Ujjala, UCSD, San Diego, California, United States
  • Kotanko, Peter, Icahn School of Medicine at Mount Sinai, New York, New York, United States
  • Garimella, Pranav S., UCSD, San Diego, California, United States
  • Trzebinska, Danuta, UCSD, San Diego, California, United States
  • Cadmus-Bertram, Lisa, UW, Madison, Wisconsin, United States
  • Ix, Joachim H., UCSD, San Diego, California, United States
  • Malhotra, Rakesh, UCSD, San Diego, California, United States

Physical decline in end stage kidney disease is associated with morbidity and mortality.The aim of this study was to quantify physical activity (PA) in hemodialysis (HD) patients using the Fitbit. We hypothesize that PA measured as by the number of daily steps will be lower in older patients, and those from a rural HD unit.


In this prospective study, 52 chronic HD patients were recruited from outpatient HD units in urban San Diego and rural Imperial County, CA between March 2018 and April 2019. Key inclusion criteria included: 1) Receiving HD for ≥3 months 2) age ≥18 years and 3) able to walk without assistance or assistive devices. All HD patients wore Fitbit Charge 2 (Fitbit, San Francisco, CA) for 4 weeks. The display of the Fitbit was covered to minimize participation bias. The primary outcome was number of steps per day.


Of 52 enrolled patients, 7 HD patients dropped out before completing 4 weeks study duration. The remaining 45 HD participants (urban=25; rural= 20) were included in the analysis. The mean age was 61 years, 42% were women and 64% were hispanic. The mean dialysis vintage was 4.4 years. On average, HD subjects walked 3687 steps per day. Elderly walked fewer steps compared to younger (age < 65 yrs) HD patients (1359 vs. 4387 steps, p=0.02). Although, not statistically significant average daily steps for participants from rural HD clinic (3141 vs. 4123 steps, respectively) and on dialysis days (3272 vs. 4070 steps,respectively) were less compared to participants from urban HD clinic and non-dialysis days. We found no difference in physical activity levels by gender and dialysis shift (Figure 1). Only about 10 percent of HD participants found activity tracker not comfortable to wear.


Participants on HD were found to be less PA on dailysis days and from rural dialysis clinic. Difference was more pronounced between younger and elderly individuals. Future studies should focus on patient-centered adaptive interventions to sustain and improve PA among HD patients.


  • Private Foundation Support