Kidney Week

Abstract: FR-PO1148

Feasibility of a Home-Based, Video-Supervised 12-Week Exercise Program in Nondialysis-Dependent CKD: The ESTEEM-VIDA Pilot Randomized Clinical Trial

Session Information

• CKD: Kidney Function and Extrarenal Complications
  October 25, 2024 | Location: Exhibit Hall, Convention Center
  Abstract Time: 10:00 AM - 12:00 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

• Welsh Osuna, Catherine Leonie, California State University Sacramento, Sacramento, California, United States

Catherine Leonie Welsh Osuna

• Gipe, Jesse, University of California Davis, Davis, California, United States

Jesse Gipe

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

Chenoa R. Vargas

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

Hiba Hamdan, MBBS

• 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

• 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 critical need for practical, safe, interactive, and personalized exercise program targeting improvements in physical functioning in patients living with CKD.

Methods

The ESTEEM-VIDA CKD pilot randomized clinical trial (NCT02923063) tested the feasibility of a home-based, video-supervised, and personalized exercise program in stage 3-5 non-dialysis CKD. Exercise consisted of 30-40min exercise sessions, thrice a week for 12 weeks. Session 1) high-intensity interval training (HIIT) targeted a hard effort with a rate of perceived exertion (RPE) above 14, session 2) strength training, and session 3) powerwalking both targeted a moderate effort with a RPE of 12-14. One week of video-supervised exercise alternated with one week of self-directed exercise. Each one-week video-supervised session was conducted by exercise trainers using a videoconference tool. Self-directed exercise weeks used pre-recorded exercise videos sent via email to participants. Feasibility was measured via adherence to the exercise dose as well as number of adverse effects and dropouts.

Results

Out of 22 participants randomized to exercise (EX), 21 completed the 12-weeks exercise program with 1 loss to follow-up. EX (n=21) had a mean age of 63±10.3 years (47% male, 47% diabetic) with mean eGFR of 35±12 mL/min/1.73 m². Adherence was 90.3% with 32 sessions (range: 14-36) completed out of 36 over 12 weeks. Only 2 (9.5%) exercisers reported less than 75% adherence. Exercisers reported average RPE of 14.3±1.3 compared to targeted RPE of above 14 for HIIT session, and RPEs of 13.9±1.8 for strength and powerwalking sessions compared to targeted RPE of 12-14. No adverse effects due to the exercise protocol were reported.

Conclusion

A 12-weeks home-based video-supervised exercise program is feasible and safe in people with moderate-severe non-dialysis CKD. Future studies should consider exercise protocol that are practical offering various exercise modality to increase participants adherence and physical functioning.

Funding: R01DK129793, R01DK125794, DCI-4112

Funding

• NIDDK Support