|Liu, Christine - Jean Mayer Human Nutrition Research Center On Aging At Tufts University|
|Milton, Jacqueline - Boston University|
|Hsu, Fang-chi - Wake Forest University|
|Beavers, Kristen - Wake Forest University|
|Yank, Veronica - Stanford University|
|Church, Timothy - Pennington Biomedical Research Center|
|Shegog, Jd - Wake Forest University|
|Kashaf, Susan - Yale University|
|Nayfield, Susan - University Of Florida|
|Newman, Anne - University Of Pittsburgh|
|Stafford, Randall - Stanford University|
|Nicklas, Barbara - Wake Forest University|
|Weiner, Daniel - Tufts University|
|Fielding, Roger - Jean Mayer Human Nutrition Research Center On Aging At Tufts University|
Submitted to: Journal of Clinical Nephrology and Renal Care
Publication Type: Peer Reviewed Journal
Publication Acceptance Date: 2/10/2017
Publication Date: 2/14/2017
Citation: Liu, C.K., Milton, J., Hsu, F., Beavers, K.M., Yank, V., Church, T., Shegog, J., Kashaf, S., Nayfield, S., Newman, A.B., Stafford, R.S., Nicklas, B.J., Weiner, D.E., Fielding, R.A. 2017. The effect of chronic kidney disease on a physical activity intervention: impact on physical function, adherence, and safety. Journal of Clinical Nephrology and Renal Care. 3:021. https://doi.org/10.23937/2572-3286.1510021.
DOI: https://doi.org/10.23937/2572-3286.1510021 Interpretive Summary: Physical activity typically improves mobility in the average older adult. However, this may not be true for older adults with chronic kidney disease. Chronic kidney disease can cause muscle wasting, and physical activity may not be appropriate for older adults with chronic kidney disease. The goal of our study was to find out if physical activity was safe and beneficial for older adults with chronic kidney disease, using information from another research study. Our study found that physical activity is both safe and likely beneficial for older adults with chronic kidney disease. Therefore, older adults with chronic kidney disease should not be hesitant about undertaking physical activity.
Technical Abstract: BACKGROUND: Because chronic kidney disease (CKD) is associated with muscle wasting, older adults with CKD are likely to have physical function deficits. Physical activity can improve these deficits, but whether CKD attenuates the benefits is unknown. Our objective was to determine if CKD modified the effect of a physical activity intervention in older adults. METHODS: This is an exploratory analysis of the LIFE-P study, which compared a 12-month physical activity program (PA) to a successful aging education program (SA) in older adults. CKD was defined as a baseline eGFR < 60 mL/min/1.73 m^2. We examined the Short Physical Performance Battery (SPPB) at baseline, 6 and 12 months. Secondary outcomes included serious adverse events (SAE) and adherence to intervention frequency. Linear mixed models were adjusted for age, sex, diabetes, hypertension, CKD, intervention, site, visit, baseline SPPB, and interactions of intervention and visit and of intervention, visit, and baseline CKD. RESULTS: The sample included 368 participants. CKD was present in 105 (28.5%) participants with a mean eGFR of 49.2 +/- 8.1 mL/min/1.73 m^2. Mean SPPB was 7.38 +/- 1.41 in CKD participants; 7.59 +/- 1.44 in those without CKD (p = 0.20). For CKD participants in PA, 12-month SPPBs increased to 8.90 (95% CI 8.32, 9.47), while PA participants without CKD increased to 8.40 (95% CI 8.01, 8.79, p = 0.43). For CKD participants in SA, 12-month SPPBs increased to 7.67 (95% CI 7.07, 8.27), while participants without CKD increased to 8.12 (95% CI 7.72, 8.52, p = 0.86). Interaction between CKD and intervention was non-significant (p = 0.88). Number and type of SAEs were not different between CKD and non-CKD participants (all p > 0.05). In PA, adherence for CKD participants was 65.5 +/- 25.4%, while for those without CKD was 74.0 +/- 22.2% (p = 0.12). CONCLUSION: Despite lower adherence, older adults with CKD likely derive clinically meaningful benefits from physical activity with no apparent impact on safety, compared to those without CKD.