Diabetes Clinical Trial
Official title:
Physical Activity and Functioning in Home Dialysis Patients
This study will compare physical activity levels and physical functioning in patients treated with home dialysis vs. those treated with in-center dialysis. The investigators will first compare prevalent patients, and will also compare the two groups longitudinally in incident patients over the first 18 months of beginning the dialysis treatments. Patients will be tested for physical functioning using standard performance-based testing such as gait speed, chair stand, balance test, as well as self-reported limitations in activities of daily living. The investigators will monitor physical activity using step counters and activity questionnaires. Blood samples will be drawn at each testing time to measure inflammatory markers. A pilot study of home dialysis patients will be done to determine the effects of an independent home-based exercise program on physical functioning and inflammatory markers. For this pilot study, 30 patients will be randomized into exercise intervention and usual care with testing at baseline and again after 3 months of the intervention.
Aim 1: To determine levels of physical functioning, physical activity, incidence of frailty
and inflammation status in prevalent home dialysis patients in the University of Utah Home
Dialysis program and compare them to in-center hemodialysis patients who are matched for
age, gender, comorbidities and dialysis vintage. Hypothesis 1: Patients on home therapies
will have higher physical functioning, be more active and fewer will be frail compared to
matched patients treated with in-center hemodialysis.
Aim 2: To determine the patterns of change in physical functioning and physical activity
over the first 18 months of initiating dialysis therapy. Hypothesis 2: Physical functioning
and physical activity will be maintained in patients initiating home dialysis therapy,
whereas, those initiating in-center dialysis will deteriorate in physical functioning and
physical activity.
Aim 3: To determine the effects of counseling and encouragement of physical activity in
prevalent home dialysis patients on physical functioning, physical activity. Hypothesis 3:
Compared to usual care, patients who are counseled and encouraged to participate in
independent home walking exercise will improve physical functioning and health-related
quality of life.
Aim 4: To determine the association of inflammation with physical functioning in home
dialysis patients and with changes in physical activity. Hypothesis 4: Lower physical
functioning is associated with inflammation and increased physical activity will improve
physical functioning and reduce the associated inflammation.
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Allocation: Randomized, Endpoint Classification: Efficacy Study, Intervention Model: Single Group Assignment, Masking: Open Label, Primary Purpose: Treatment
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