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Kidney Week

Abstract: PO0586

A Pilot and Feasibility Randomized Clinical Trial Targeting Sedentary Behavior in CKD: Sit Less, Interact and Move More (SLIMM) Study

Session Information

Category: CKD (Non-Dialysis)

  • 2102 CKD (Non-Dialysis): Clinical, Outcomes, and Trials

Authors

  • Boucher, Robert E., Division of Nephrology & Hypertension, University of Utah School of Medicine, Salt Lake City, Utah, United States
  • Wei, Guo, Division of Nephrology & Hypertension, University of Utah School of Medicine, Salt Lake City, Utah, United States
  • Greene, Tom, Division of Biostatistics, University of Utah School of Medicine, Salt Lake City, Utah, United States
  • Beddhu, Srinivasan, Division of Nephrology & Hypertension, University of Utah School of Medicine, Salt Lake City, Utah, United States
Background

Sedentary behavior (engaging in activities in the seated/ lying position) is highly prevalent and associated with mortality in CKD.

Methods

In a 24-week pilot and feasibility RCT, we tested the feasibility of a ‘Sit Less, Interact, Move More (SLIMM)’ intervention to replace sedentary activities with casual stepping activities in CKD. Participants wore an accelerometer for 7 days before randomization to measure baseline sedentary and stepping durations. In the SLIMM group (N=54), these data were used to develop individualized plans targeting sedentary behavior; accelerometry was repeated every 4 weeks to monitor adherence and to provide personalized feedback. The standard of care (SOC) group (N=52) were provided physical activity guidelines and underwent folloow-up accelerometry at weeks 8, 16 and 24.

Results

Mean age was 69 ±13 yrs, 42% were women. 5%, 38%, 43% and 14% had CKD stages 2, 3A, 3B/4 and ESKD, respectively. Sedentary and stepping durations did not change in the SOC group. In the SLIMM group, the maximum decrease in sedentary duration, increase in stepping duration, and the number of steps/day, were seen at week 20 but attenuated at week 24 (Fig1). In separate linear mixed effects models (Table 1), overall treatment effects of the intervention on sedentary duration, stepping duration and the number of steps were not significant. The SLIMM intervention significantly reduced BMI and body fat%.

Conclusion

It is feasible to reduce sedentary duration and increase stepping duration in CKD but additional measures along with SLIMM intervention may be needed to sustain its effect on sedentary behavior.

Mixed effects models of treatment effects in SLIMM vs. Stand of Care groups
 Mean change (95% CI)p-value
Sedentary duration, min/d-15.6 (-41.0, 9.6)0.22
Stepping duration, min/d6.5 (-2.7, 15.6)0.16
Number of steps/d631 (-166, 1429)0.12
Body mass index, kg/m2-1.09 (-1.92, -0.26)0.010
Body fat, %-2.29 (-4.44, -0.14)0.038

Least square means estimates of sedentary and stepping durations and the number of steps/day by intervention group

Funding

  • NIDDK Support