P52
PHYSICAL INACTIVITY, DISEASE SEVERITY AND THE PATIENT PERSPECTIVE
IN THE UK CHRONIC KIDNEY DISEASE POPULATION
Hull, K1, Clarke, A1, Stone, M2, Hudson, N3, Burton J1,4 , Smith A1,4
1
Department of Infection, Immunity and Inflammation, University of Leicester,
2
Department of Health Sciences, University of Leicester, 3School of Applied Social
Sciences, De Montfort University, 4Leicester Kidney Exercise Team, University Hospitals
of Leicester
BACKGROUND: Chronic kidney disease (CKD) has numerous long term physiological and
psychological complications that lead to increased morbidity and poor quality of life. These
include accelerated cardiovascular disease, muscle wasting, functional decline and depression.
Although exercise has the potential to impact upon all of these factors, its incorporation into
routine care of CKD patients has been slow. In order to address this issue effectively,
understanding of the current activity levels, attitudes and behaviours of the UK CKD population
is required.
AIMS: To investigate physical activity levels, exercise habits and readiness to change, and their
relationship with markers of diseases severity, in patients with CKD.
METHODS: 350 CKD outpatients (190 male, age range 21-93 years, eGFR range 590mL/min/1.73m2) completed a series of four validated questionnaires: (1) GP Physical Activity
Questionnaire [GPPAQ] to classify activity status, (2) Duke Activity Status Index [DASI] to
measure functional capacity, (3) Leisure Time Exercise Questionnaire [LTEQ] to further
explore exercise habits, (4) Stage of Change Questionnaire [SOCQ] to establish readiness to
change exercise behaviour. Biochemical markers of disease severity were extracted from the
clinical records with patient consent.
RESULTS: The GPPAQ responses classified 30% of patients with CKD stages 1-3 and 43% of
patients with CKD stages 4-5 as either inactive or moderately inactive. The DASI showed
significant positive correlation with the LTEQ (p<0.001), and with eGFR (p<0.001),
haemoglobin (p<0.001), cholesterol (p=0.001), albumin (p<0.001) and bicarbonate (p=0.028),
demonstrating that inactivity is linked with declining renal function, renal anaemia, poor
nutritional status and acidosis. The SOCQ showed that while only 25% of patients exercised
regularly, 47% were contemplating increasing their physical activity levels.
CONCLUSIONS: These results demonstrate a high level of sedentary behaviour within the UK
CKD population, with inactivity levels increasing as CKD progresses. Although activity levels
were low, nearly half of the patients were considering the possibility of taking up exercise,
suggesting that they are aware of potential benefits and may be open to behaviour change. This
indicates a requirement for exercise provision, education and facilitation in CKD management
to promote health and wellbeing and enhance the patient experience.