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Abstract: PO1756

Physical Activity Scores in Hemodialysis Patients with Thyroid Dysfunction: A Substudy of the NIH THYROID-HD Trial

Session Information

Category: Health Maintenance, Nutrition, and Metabolism

  • 1300 Health Maintenance, Nutrition, and Metabolism

Authors

  • Otobe, Yuhei, University of California Irvine, Irvine, California, United States
  • Casaburi, Richard, The Lundquist Institute, Torrance, California, United States
  • Rossiter, Harry B., The Lundquist Institute, Torrance, California, United States
  • Radom-Aizik, Shlomit, University of California Irvine, Irvine, California, United States
  • Kopple, Joel D., The Lundquist Institute, Torrance, California, United States
  • Budoff, Matthew Jay, The Lundquist Institute, Torrance, California, United States
  • Bross, Rachelle, The Lundquist Institute, Torrance, California, United States
  • Cervantes, Mackenzie Kerr, The Lundquist Institute, Torrance, California, United States
  • Brent, Gregory, University of California Los Angeles David Geffen School of Medicine, Los Angeles, California, United States
  • Kovesdy, Csaba P., The University of Tennessee Health Science Center College of Medicine, Memphis, Tennessee, United States
  • Guerrero, Yalitzi, University of California Irvine, Irvine, California, United States
  • Narasaki, Yoko, University of California Irvine, Irvine, California, United States
  • You, Amy Seung, University of California Irvine, Irvine, California, United States
  • Nguyen, Danh V., University of California Irvine, Irvine, California, United States
  • Kalantar-Zadeh, Kamyar, University of California Irvine, Irvine, California, United States
  • Rhee, Connie, University of California Irvine, Irvine, California, United States
Background

Low physical activity is common in hemodialysis (HD) patients and is associated with adverse outcomes in this population (poor health-related quality of life, cardiovascular [CV] disease, death). Prior studies show that hypothyroidism is highly prevalent in HD patients, and is associated with worse self-reported physical function.

Methods

In a substudy of the ongoing multi-center NIH THYROID-HD Trial, we examined baseline physical activity scores determined by the Human Activity Profile (HAP), a validated 94-item instrument assessing daily activities across a wide range of energy expenditures, in HD patients with TSH levels in the high-normal (TSH >3-5 mIU/L) and subclinical hypothyroid range (TSH >5-10 mIU/L). The HAP was used to derive the Maximum Activity Score (MAS) and Adjusted Activity Score (AAS), representing greatest and mean estimated energy expenditures, respectively (range 0-94, segmented to low [<52], moderate [54-73], and high [>74] scores).

Results

Among 57 HD patients who underwent baseline HAP assessment, the mean±SD MAS and AAS scores were 52±21 and 26±27, respectively; median (IQR) MAS and AAS scores were 52 (40, 68) and 22 (0, 49), respectively. In the overall cohort, 79% had low, 14% moderate, and 7% high AAS scores. MAS scores were lower in patients who were older (≥65 yrs), female, White, Hispanic, of longer (>1 yr) vintage, diabetic, or with underlying CV disease. A similar trend was observed for AAS scores.

Conclusion

In this substudy of the NIH THYROID-HD Trial, HAP scores in HD patients with high-normal and subclinical hypothyroid range TSH levels were lower than observed in prior historical dialysis cohorts that did not have underlying thyroid dysfunction. Further research is needed to determine the impact of thyroid hormone replacement on improving physical activity and function in this population.

Funding

  • NIDDK Support