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Kidney Week

Abstract: TH-PO779

Physician Practices Regarding Physical Activity Restriction in Pediatric Hemodialysis Patients: A Qualitative Study

Session Information

  • Pediatric CKD
    November 07, 2019 | Location: Exhibit Hall, Walter E. Washington Convention Center
    Abstract Time: 10:00 AM - 12:00 PM

Category: Pediatric Nephrology

  • 1700 Pediatric Nephrology

Authors

  • Dandamudi, Raja, Washington University in St. Louis School of Medicine, Glencoe, Missouri, United States
  • Twombley, Katherine, Medical University of South Carolina, Charleston, South Carolina, United States
  • Flynn, Joseph T., Seattle Children's Hospital, Seattle, Washington, United States
  • Kakajiwala, Aadil K., Washington University in St Louis, St. Louis, Missouri, United States
  • Chand, Deepa H., Abbvie, Chicago, Illinois, United States
Background

Children with chronic kidney disease (CKD) due to multiple hospitalizations and interventions have less physical activity. This sedentary lifestyle in CKD is associated with a higher cardiovascular mortality risk. In those patients receiving hemodialysis (HD) time spent on dialysis and restrictions on physical activity due to access also contribute. No consensus exists regarding physical activity restrictions based on vascular access type. The aim of the study is to assess pediatric nephrologists’ practices regarding physical activity restrictions in children receiving HD.

Methods

The study was conducted through the Midwest Pediatric Nephrology Consortium using an anonymous, self-administered survey of pediatric nephrologists to evaluate the activity restrictions placed on HD patients with arteriovenous fistulae (AVF) and central venous catheters (CVC).The survey consisted of 19 items, 6 questions detailed physician characteristics with the subsequent 13 addressing physical activity restrictions.

Results

35 responses (35% response rate) were received
Average years in practice after fellowship: 11.5 years (range: 1-35).Dialysis units had 1– 12 stations( mean 6)
Physical activity restrictions by physicians are summarized in tables.
None of the participants reported accesses damage or loss that was attributed to physical activity and sport participation.
Physicians practice is based on their personal experience, standard practice at their hemodialysis center and the clinical practices they were taught.

Conclusion


There is no consensus amongst pediatric nephrologists about physical activity that can be allowed in children receiving HD. Due to the lack of objective data, individual physician beliefs have been utilized to restrict activities in the absence of any deleterious effects to accesses.
This survey clearly demonstrates the need for more prospective and detailed studies and guidelines regarding the physical activity and dialysis access care in order to optimize quality of care in these children.