Kidney Week

Abstract: FR-OR07

A Home-Based, Video-Supervised 12-Week Exercise Program Improves Physical Performance in CKD: Results from a Pilot Randomized Controlled Trial

Session Information

• CKD: Care Patterns and Novel Therapeutic Approaches
  October 25, 2024 | Location: Room 25, Convention Center
  Abstract Time: 05:30 PM - 05:40 PM

Category: CKD (Non-Dialysis)

• 2302 CKD (Non-Dialysis): Clinical, Outcomes, and Trials

Authors

• Begue, Gwenaelle, California State University Sacramento, Sacramento, California, United States

Gwenaelle Begue, PhD

• Foster, Alec, California State University Sacramento, Sacramento, California, United States

Alec Foster

• Lopez, Amanda Marie Figueroa, University of California Davis, Davis, California, United States

Amanda Marie Figueroa Lopez

• Kaethler, Lynea Brubacher, University of California Davis, Davis, California, United States

Lynea Brubacher Kaethler, MSc

• Vargas, Chenoa R., University of California Davis, Davis, California, United States

Chenoa R. Vargas

• Kim, Tae Youn, University of California Davis, Davis, California, United States

Tae Youn Kim, PhD, RN

• Jue, Thomas, University of California Davis, Davis, California, United States

Thomas Jue, PhD

• Hamdan, Hiba, University of California Davis, Davis, California, United States

Hiba Hamdan, MBBS

• Gamboa, Jorge, Vanderbilt University, Nashville, Tennessee, United States

Jorge Gamboa, MD, PhD

• Roshanravan, Baback, University of California Davis, Davis, California, United States

Baback Roshanravan, MD, MS, MPH, FASN

Background

Sarcopenia is prevalent in CKD and is a central component of the frailty phenotype associated with adverse clinical outcomes. Regular exercise improves muscle function and physical capacity in CKD. There is a need to test the efficacy of practical and personalized exercise program on improving physical functioning in CKD.

Methods

We performed a 12-week pilot randomized (3:1) clinical trial (NCT02923063) of home-based, personalized, and video-supervised exercise intervention (EX), compared to usual care (UC) in stage 3-5 non-dialysis CKD. Pre- and post-intervention cardiorespiratory fitness (VO2peak) and total work were measured using a graded cycle ergometer test and physical performance was assessed by the 6-minutes walking distance (6MWT) test. Linear mixed effects models were used to test changes in cardiorespiratory fitness, total work, and physical performance comparing 12-week and baseline measurements.

Results

Participants randomized to EX (n=21, 47% male, 47% diabetic) had a mean eGFR of 35±12 mL/min/1.73m2 and mean age of 63±10.3 years, compared to 32.3±12 mL/min/1.73m2 and 67.1±8.3 years for those randomized to UC (n=9, 22% male, 44% diabetic). EX led to improved endurance with significant (p<0.05) 5.25kJ increase in total work (95% CI:0.70-6.43, p=0.008) at the graded cycle test and a clinically meaningful improvement of 39m at 6MWT (95% CI:3-52, p=0.02) compared to UC (Fig. 1). Cardiorespiratory fitness (VO2 peak) did not differ between groups (p=0.3). The increase in total work was independent of change in VO2 peak, suggesting improved muscular health in EX.

Conclusion

A 12-weeks home-based video-supervised exercise program is efficacious in improving physical endurance in CKD. It provides a tool for studying metabolic and molecular health and may shed new light on the pathophysiology of sarcopenia in CKD.
Funding: R01DK129793, R01DK125794, DCI-4112

Funding

• NIDDK Support