Evaluation of the physical activity level of chronic kidney disease patients undergoing hemodialysis

Abstract

The recommendation of energy intake is based on the total energy expenditure, which has resting energy expenditure (60-75%) and physical activity (15-30%) as the major components. Studies show that in chronic kidney disease patients the resting energy expenditure is reduced or similar to that of healthy individuals. Moreover, there are evidence of the important role of the comorbidities such as hyperparathyroidism, diabetes, and inflammation increasing the resting energy expenditure in this population. Although advances have occurred in the investigations concerning resting energy expenditure in chronic kidney disease patients, the physical activity is an issue scarcely explored in this population. Therefore, the present study aimed to evaluate physical activity level in patients undergoing hemodialysis. It will be included 40 patients on hemodialysis at the Dialysis Unit of the Federal University of São Paulo. The exclusion criteria are age <18 years, length on dialysis <3 months, hospitalization in the month prior to the study, amputation, severe cardiopulmonary diseases, neurological diseases, and malignance. A control group of healthy individuals, pair-matched by sex and age, with sedentary or light active lifestyle will be formed. The total energy expenditure will be assessed by a biaxial accelerometer, which also provides data of energy expended by physical activity. The questionnaires Physical Activity Scale for the Elderly and Stanford 7-day Physical Activity Recall will be applied for evaluating the level of physical activity. The resting energy expenditure will be evaluated by indirect calorimetry. Body composition will be assessed by dual energy X-ray absorptiometry and bioelectrical impedance. It will be also included measurements of anthropometry (body mass index, arm and abdominal circumferences, and triceps skinfold thickness), subjective global assessment of the nutritional status, muscle strength by dynamometer, and laboratorial parameters (creatinine, urea, hematocrit, hemoglobin, albumin, glucose, glycated haemoglobin, insulin, parathyroid hormone, thyroid stimulating hormone, serum bicarbonate, and C-reactive protein).