Kidney Week

Abstract: FR-PO807

Associations Between Submaximal Indices of Physical Function and VO2 Peak in Patients on Hemodialysis

Session Information

• Health Maintenance, Nutrition, Metabolism - II
  November 03, 2023 | Location: Exhibit Hall, Pennsylvania Convention Center
  Abstract Time: 10:00 AM - 12:00 PM

Category: Health Maintenance, Nutrition, and Metabolism

• 1500 Health Maintenance, Nutrition, and Metabolism

Authors

• Arroyo, Eliott, Indiana University School of Medicine, Indianapolis, Indiana, United States

Eliott Arroyo,

• Burney, Heather, Indiana University School of Medicine, Indianapolis, Indiana, United States

Heather Burney,

• Dillman, Drake, Indiana University School of Medicine, Indianapolis, Indiana, United States

Drake Dillman,

• Sher, Syed Jawad, Indiana University School of Medicine, Indianapolis, Indiana, United States

Syed Jawad Sher,

• Karp, Sharon L., Indiana University School of Medicine, Indianapolis, Indiana, United States

Sharon L. Karp,

• Moe, Sharon M., Indiana University School of Medicine, Indianapolis, Indiana, United States

Sharon M. Moe,

• Lim, Kenneth, Indiana University School of Medicine, Indianapolis, Indiana, United States

Kenneth Lim,

Background

Cardiopulmonary exercise testing (CPET) is well-recognized as the gold standard tool for quantifying cardiovascular functional capacity (as assessed by peak oxygen uptake, VO₂Peak during exercise). VO₂Peak is a strong predictor of survival in patients with chronic kidney disease (CKD). It is currently unknown whether basic submaximal tests can reliably predict VO₂Peak in patients with advanced CKD. Herein, we sought to compare the association between various submaximal assessments of physical function with VO₂Peak in patients on hemodialysis.

Methods

We analyzed data from the ongoing, “Effects of long interdialytic intervals on Cardiovascular Functional Capacity (ECON)” study, a randomized crossover trial of patients on hemodialysis. All participants underwent CPET and a battery of submaximal tests of physical function and mobility on a non-dialysis day. Multivariable step regression analysis was used to assess the association between the submaximal tests and VO₂Peak.

Results

A total of 30 patients were stratified based on the median VO₂Peak value of 11.2 mL/kg/min into a High group (n=15, 11 [73%] men, age=54 [11]; VO₂Peak=14.4 [2.5] mL/kg/min) and a Low group (n=15, 8 [53%] men, age=56 [12] ]; VO₂Peak=9.8 [1.3] mL/kg/min). The High group had a lower BMI (26.7 [5.9] kg/m²) compared to the Low group (33.6 [7.4] kg/m²; p=0.008). No group differences were observed in age, sex, race/ethnicity, dialysis vintage, hypertension, or diabetes (all p’s>0.05). The High group had a higher balance score (p=0.003), faster usual gait speed (p<0.001), faster time to complete 5 sit-to-stands (STS-5; p=0.013), longer distance walked during the 6-min walk test (p=0.003), and higher scores in the SF36-PFS (p=0.012) and PROMIS Mobility (p=0.004) questionnaires. After adjusting for age, sex, BMI, and diabetes, only STS-5 (ß [SE]=-0.51 [0.20]; p=0.022) remained significantly associated with VO₂Peak.

Conclusion

Our results indicate that the STS-5, a simple submaximal test that can be completed in less than 1 minute, is superior to the 6-min walk test, usual gait speed, and SF36-PFS and PROMIS Mobility questionnaires for predicting VO₂Peak in dialysis patients.

Funding

• NIDDK Support – Dialysis Clinic, Inc.