Senior Pediatric Renal Dietitian Texas Children's Hospital Houston, Texas, United States
Background: Children with chronic kidney disease (CKD) are immensely vulnerable to the effects of physical inactivity given their higher morbidity and mortality risk imparted by their lifelong disease process. Children in advanced stages of CKD exhibit poor health-related quality of life (HRQoL) and have the lowest physical fitness levels. The role of physical activity in children with CKD as an adjunct therapy to improving both HRQoL and physical fitness has not been well studied. Physical activity programs suffer from high attrition rates and poor adherence. Objective: Our aim to is evaluate the feasibility of a pilot physical activity intervention and assess its effects on HRQoL and physical fitness. Design/Methods: Children with CKD 2-4/5 (n=40) will be randomized with CKD stage and sex as stratification factors to a physical activity or a waitlist-intervention control (WIC) group. The physical activity treatment group will participate in a 12-week individualized, telehealth intervention aimed at achieving 150 minutes/week of moderate to vigorous activity at the end of the intervention. The WIC group will receive standard of care for the initial 13-16 weeks while maintaining habitual physical activity levels and will then be offered the opportunity to participate in the same physical activity intervention protocol as the treatment group. Primary (physical activity levels, HRQoL, attrition, adherence) and secondary (cardiorespiratory fitness, mobility, muscular fitness) outcomes metrics and covariates (demographics, body composition, disease characteristics) will be assessed at baseline and at the end of the intervention period (13 weeks). The WIC will receive a total of 3 time points measuring outcomes and covariates (baseline, 13-16 weeks, 25-28 weeks). Statistical analysis will evaluate outcomes across groups with analysis of covariance controlling for baseline values and per-protocol and intention-to-treat techniques will be used as needed. IRB approval has been attained and is active. Enrollment will be completed by December 2023 and final measures taken by February 2024.
