Supervised exercise intervention and overall activity in chronic kidney disease.

Abstract Introduction Patients are often instructed to engage in multiple weekly sessions of exercise to increase physical activity. We aimed to determine whether assignment to a supervised exercise regimen increases overall weekly activity in individuals with chronic kidney disease (CKD). Methods We performed a secondary analysis of a pilot randomized 2x2 factorial design trial examining the effects of diet and exercise (10-15% reduction in caloric intake, three supervised exercise sessions/week, combined diet restriction/exercise, and control). Activity was measured as counts detected by accelerometer. Counts data were collected on all days for which an accelerometer was worn at baseline, month 2, and month 4 follow-up. The primary outcome was a relative change from baseline in log-transformed counts/minute. Generalized estimating equations were used to compare the primary outcome in individuals in the exercise group and the non-exercise group. Results We examined 111 individuals randomized to aerobic exercise or usual activity (n=48 in exercise group and n=44 controls). The mean age was 57 years, 42% were female, and 28% were black. Median overall adherence over all time was 73%. Median (25th, 75th percentile) counts/minute over non-supervised exercise days at months 2 and 4 were 237.5 (6.5, 444.4) for controls and 250.9 (7.7, 529.8) for the exercise group (p=0.74). No difference was observed in the change in counts/min between the exercise and control groups over three time points (Beta (fold change): 0.96, 95% CI: 0.91, 1.02). Conclusions Engaging in supervised exercise program does not increase overall weekly physical activity in individuals with Stage 3-4 CKD.