Kidney Week

Abstract: SA-PO0902

Physical Activity and Glycemic Outcomes in Patients on Maintenance Dialysis

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

• Rivas-Nieto, Andrea Cecilia, Kidney Research Institute, University of Washington, Seattle, Washington, United States

Andrea Cecilia Rivas-Nieto, MD, MPH

• Zelnick, Leila R., Kidney Research Institute, University of Washington, Seattle, Washington, United States

Leila R. Zelnick, PhD, FASN

• Hall, Yoshio N., Kidney Research Institute, University of Washington, Seattle, Washington, United States

Yoshio N. Hall, MD, MS

• Bansal, Nisha, Kidney Research Institute, University of Washington, Seattle, Washington, United States

Nisha Bansal, MD, FASN

• Hsu, Simon, Kidney Research Institute, University of Washington, Seattle, Washington, United States

Simon Hsu, MD, MS

• Limonte, Christine P., Kidney Research Institute, University of Washington, Seattle, Washington, United States

Christine P. Limonte, MD, MSc

• Mayeda, Laura, Kidney Research Institute, University of Washington, Seattle, Washington, United States

Laura Mayeda, MD, MPH

• Lidgard, Benjamin, Kidney Research Institute, University of Washington, Seattle, Washington, United States

Benjamin Lidgard, MD

• Ayers, Ernest, Kidney Research Institute, University of Washington, Seattle, Washington, United States

Ernest Ayers

• Linke, Lori, Kidney Research Institute, University of Washington, Seattle, Washington, United States

Lori Linke

• Jones, Evelin Noemi, Kidney Research Institute, University of Washington, Seattle, Washington, United States

Evelin Noemi Jones

• Hirsch, Irl B., University of Washington Division of Metabolism Endocrinology and Nutrition, Seattle, Washington, United States

Irl B. Hirsch, MD

• Trikudanathan, Subbulaxmi, University of Washington Division of Metabolism Endocrinology and Nutrition, Seattle, Washington, United States

Subbulaxmi Trikudanathan, MD

• Tang, Mengyao, Division of Nephrology, Department of Medicine, Massachusetts General Hospital, Boston, Massachusetts, United States

Mengyao Tang, MD, MPH, FASN

• Gaynanova, Irina, University of Michigan Department of Biostatistics, Ann Arbor, Michigan, United States

Irina Gaynanova, MS, PhD

• Hoofnagle, Andrew N., Kidney Research Institute, University of Washington, Seattle, Washington, United States

Andrew N. Hoofnagle, MD, PhD

• Mehrotra, Rajnish, Kidney Research Institute, University of Washington, Seattle, Washington, United States

Rajnish Mehrotra, MD, MS, FASN

• de Boer, Ian, Kidney Research Institute, University of Washington, Seattle, Washington, United States

Ian de Boer, MD, MS

Background

Kidney failure reduces physical activity (PA) and alters glucose homeostasis through impaired gluconeogenesis and dialysis-induced glucose fluctuations, making the association between PA and glycemic control uncertain. We examined this association in maintenance dialysis patients with and without diabetes mellitus (DM).

Methods

400 ambulatory participants on maintenance dialysis with and without DM from the BLOSSOM cohort wore a Dexcom G6 Pro CGM for ~10 days. We assessed associations of self-reported PA (minimal movement for necessary chores [MM] vs. any regular PA [at least 1-2x/week]) with time in range (TIR; 70-180 mg/dL with DM, 70-140 mg/dL without DM) using multivariable linear regression, stratified by DM status and treatment. Secondary CGM outcomes included mean glucose (MG), and glycemic variability (CV); interactions by DM status were tested for MG and CV. In a subset wearing a Fitbit ≥3 days (N=42), we correlated daily step count with TIR.

Results

Participants had mean age 60 years (SD 14); 61% were male, 62% had DM, and 13% were on peritoneal dialysis. 40% reported MM and 60% reported any regular PA. TIR was higher with any regular PA than with MM (62.6% vs. 56.5%; adjusted difference [aD] 6.9 percentage points [pp], 95% CI: 1.5,12.2) (Table). In stratified analyses, this association was strongest in participants without DM (aD 9.1pp, 95% CI: 2.2, 15.9) and was not significant in those with untreated or treated DM. MG was 8.3 mg/dL lower with any regular PA versus MM (p>0.05). CV did not differ between any regular PA and MM; however, the interaction by DM status was significant (p=0.03). In exploratory analyses, compared with MM, any regular PA was associated with lower CV in participants without DM (aD -1.6, 95% CI -2.9, -0.2) and higher CV in those with treated DM (2.7, 95% CI 0.4, 5.0). In the Fitbit subset, daily steps correlated with TIR (r=0.34, p=0.02; median 10 [IQR 7-13] wear days).

Conclusion

In maintenance dialysis, PA was associated with higher TIR. These findings suggest PA may improve glycemic control and motivate PA interventions in dialysis care.

Acknowledgment

The authors thank the BLOod Sugar Sensing On Maintenance dialysis (BLOSSOM) study participants and the staff of Northwest Kidney Centers. The BLOSSOM study was funded by R01DK126373. CGM equipment and supplies were provided by Dexcom.

Funding

• NIDDK Support – CGM equipment and supplies were provided by Dexcom.