Abstract: SA-PO0912
Real-World Physical Function Measures Predict Risk of ESKD or Death in Patients with CKD
Session Information
- Health Maintenance, Nutrition, and Metabolism
October 24, 2026 | Location: Exhibit Hall A, Convention Center
Abstract Time: 10:00 AM - 12:00 PM
Category: Health Maintenance, Nutrition, and Metabolism
- 1500 Health Maintenance, Nutrition, and Metabolism
Authors
- Akramimoghadam, Farideh, Cardiovascular, Renal and Metabolism Center, University of Utah, Salt Lake City, Utah, United States
- Katkam, Niharika, Cardiovascular, Renal and Metabolism Center, University of Utah, Salt Lake City, Utah, United States
- Chakravartula, Akhil Ramanujam, Cardiovascular, Renal and Metabolism Center, University of Utah, Salt Lake City, Utah, United States
- Melo, Isabelle, Cardiovascular, Renal and Metabolism Center, University of Utah, Salt Lake City, Utah, United States
- Umbacia, Ana, Cardiovascular, Renal and Metabolism Center, University of Utah, Salt Lake City, Utah, United States
- Hamm, Kaila Madison, Cardiovascular, Renal and Metabolism Center, University of Utah, Salt Lake City, Utah, United States
- Boucher, Robert E., Cardiovascular, Renal and Metabolism Center, University of Utah, Salt Lake City, Utah, United States
- Lyden, Kate, KAL Research & Consulting LLC, Denver, Colorado, United States
- Beddhu, Srinivasan, Cardiovascular, Renal and Metabolism Center, University of Utah, Salt Lake City, Utah, United States
Background
Real-world (RW) physical function measures could be derived from actigraphy but whether they predict hard endpoints such as ESKD/ death in CKD is unknown.
Methods
The SLIMM pilot RCT examined the effects of a sedentary behavior intervention on sedentary duration in 106 CKD participants recruited at the University of Utah from March 2017–December 2018. Current study included those without ESKD at baseline and extended follow-up via EHR through March 31, 2026. Each standard deviation (SD) of change in baseline RW (best 6-minute step count (B6SC) and rise time from thigh-worn accelerometry) and in-clinic (6-min walk, 4-m gait speed, shuttle walk) measures were related to progression to ESKD/ death composite in multivariable Cox models adjusted for variables listed in Figure.
Results
Baseline characteristics are summarized in Table. During 695 patient-years of follow-up, 26 ESKD/death events occurred, including 7 ESKD events. Of the in-clinic measures, shuttle walk distance and of the RW measures, B6SC independently predicted ESKD/death composite (Figure).
Conclusion
B6SC, a RW physical function measure was a strong, iindependent predictor of ESKD/ death in CKD patients. These results support the use of B6SC as a measure of physical function in clinical practice and research settings.
Baseline characteristics by B6SC tertiles
| Entire Cohort, N=96 | B6SC < 468 steps, n=34 | B6SC 468–584 steps, n=30 | B6SC > 584 steps, n=32 | |
| B6SC, steps | 521 ± 126 | 386 ± 69 | 525 ± 38 | 662 ± 42 |
| SLIMM group randomization, % | 51 | 47 | 47 | 59 |
| Age, yrs | 71 ± 11 | 71 ± 11 | 71 ± 10 | 71 ± 13 |
| Female, % | 43 | 44 | 57 | 28 |
| White race, % | 94 | 91 | 97 | 94 |
| BMI, kg/m2 | 30.4 ± 3.7 | 32.2 ± 4.3 | 29.7 ± 2.9 | 29.2 ± 2.9 |
| CKD stage 3B/4/5, % | 54 | 53 | 56 | 50 |
| 6 min walk distance (m) | 387 ± 67 | 372 ± 68 | 387 ± 67 | 403 ± 64 |
| Gait speed (m/s) | 1.05 ± 0.19 | 1.02 ± 0.17 | 1.03 ± 0.22 | 1.09 ± 0.18 |
| Shuttle walk distance (m) | 251 ± 118 | 215 ± 95 | 276 ± 135 | 265 ± 116 |
| Sedentary minutes/day | 645 ± 126 | 673 ± 105 | 642 ± 110 | 619 ± 156 |
| MVPA minutes/day | 17.4 ± 32.6 | 6.1 ± 7.6 | 12.5 ± 9.5 | 34.0 ± 51.6 |
| Steps per day | 6057 ± 3644 | 4444 ± 1860 | 5955 ± 1977 | 7868 ± 5207 |
| Rise time (s) | 0.97 ± 0.20 | 0.99 ± 0.18 | 0.94 ± 0.19 | 0.98 ± 0.22 |
Forest plot relating each SD change in physical function measures with ESKD/death
Funding
- NIDDK Support