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Kidney Week

Abstract: PO0824

Change in Physical Activity and Function in Patients with Baseline Advanced Non-Dialysis CKD

Session Information

Category: Dialysis

  • 701 Dialysis: Hemodialysis and Frequent Dialysis

Authors

  • Rampersad, Christie, University of Manitoba Faculty of Health Sciences, Winnipeg, Manitoba, Canada
  • Harasemiw, Oksana, Chronic Disease Innovation Centre, Winnipeg, Manitoba, Canada
  • Brar, Ranveer Singh, Chronic Disease Innovation Centre, Winnipeg, Manitoba, Canada
  • Komenda, Paul, Chronic Disease Innovation Centre, Winnipeg, Manitoba, Canada
  • Rigatto, Claudio, Chronic Disease Innovation Centre, Winnipeg, Manitoba, Canada
  • Prasad, Bhanu, Saskatchewan Health Authority, Saskatoon, Saskatchewan, Canada
  • Bohm, Clara, Chronic Disease Innovation Centre, Winnipeg, Manitoba, Canada
  • Tangri, Navdeep, Chronic Disease Innovation Centre, Winnipeg, Manitoba, Canada
Background

Progressive declines in physical activity and function are common in individuals with worsening chronic kidney disease (CKD). However, little is known about whether the transition to dialysis is associated with accelerated decline. We aimed to assess temporal rates of change in physical activity level and physical function in people with advanced CKD to determine whether the transition to dialysis was associated with accelerated decline.

Methods

Individuals with advanced CKD stages G4-G5 from the Canadian Frailty Observation and Interventions Trial (CanFIT) were included. Outcomes included change in physical activity level measured using the Physical Activity Scale for the Elderly (PASE) and physical function measured using the chair stand test, 4-meter gait speed, and grip strength. Unadjusted and adjusted generalized linear regression models were conducted to determine whether progression to dialysis was associated with greater decline in physical activity or physical function.

Results

Of 386 individuals, 162 individuals progressed to dialysis during the study period, whereas 224 did not. Both groups experienced statistically significant declines in self-reported physical activity, increased chair stand test times, and decreased gait speed. Compared to individuals with advanced nondialysis CKD, progression to dialysis was associated with greater increase in chair stand test time in unadjusted (beta estimate 6.05 seconds, 95% CI 2.36 – 9.74, p=0.001) and adjusted (beta estimate 5.23 seconds, 95% CI 0.75 – 9.71, p=0.02) models.

Conclusion

Although individuals with advanced CKD experience declines in physical activity and function over time, progression to dialysis is associated with accelerated decline in physical function as measured by the chair stand test. Future studies on interventions to delay or prevent declines associated with CKD progression and dialysis initiation are needed.