Renal Unit, Lister Hospital, Corey's Mill Lane, Stevenage, UK.
Life and Medical Sciences, University of Hertfordshire, Hatfield, UK.
Nephrol Dial Transplant. 2022 Feb 25;37(3):515-521. doi: 10.1093/ndt/gfaa377.
Physical activity (PA) levels are low in patients with advanced chronic kidney disease (CKD), and associate with increased morbidity and mortality. Reliable tools to assess PA in CKD are scarce. We aimed to develop and validate a novel PA questionnaire for use in CKD (CKD-PAQ).
In Phase 1, a prototype questionnaire was developed based on the validated recent PAQ (RPAQ). Structured feedback on item relevance and clarity was obtained from 40 CKD patients. In Phase 2, the questionnaire was refined in three iterations in a total of 226 CKD patients against 7-day accelerometer and RPAQ measurements. In Phase 3, the definitive CKD-PAQ was compared with RPAQ in 523 CKD patients.
In the final iteration of Phase 2, CKD-PAQ data were compared with accelerometer-derived and RPAQ data in 60 patients. Mean daily metabolic equivalent of task (MET) and total energy expenditure (TEE) levels were similar by all methods. Intraclass correlation coefficients showed fair (MET) and good (TEE) agreement between accelerometry and both CKD-PAQ and RPAQ. Agreement between questionnaires was excellent. The mean [standard deviation (SD)] daily MET bias was 0.035 (0.312) for CKD-PAQ and 0.018 (0.326) for RPAQ. The mean (SD) TEE bias was 91 (518) for CKD-PAQ and 44 (548) kcal for RPAQ. Limits of agreement (LOA) were wide for both parameters, with less dispersion of CKD-PAQ values. In Phase 3, agreement between questionnaires was good (MET) and excellent (TEE). Bias of CKD-PAQ-derived mean (SD) daily MET from RPAQ-derived values was 0.031 (0.193), with 95% LOA -0.346 to 0.409. Corresponding mean (SD) values for TEE were 48 (325) and -588 to 685 kcal/day. CKD-PAQ appeared to improve discrimination between low activity groups.
CKD-PAQ performs comparably to the RPAQ though it is shorter, easier to complete, and may better capture low-level activity and improve discrimination between low activity groups.
在晚期慢性肾脏病（CKD）患者中，体力活动（PA）水平较低，与发病率和死亡率增加有关。可靠的工具来评估 CKD 中的 PA 是稀缺的。我们旨在开发和验证一种用于 CKD 的新型 PA 问卷（CKD-PAQ）。
在第 1 阶段，根据经过验证的近期 PAQ（RPAQ）开发了原型问卷。从 40 名 CKD 患者那里获得了关于项目相关性和清晰度的结构化反馈。在第 2 阶段，在总共 226 名 CKD 患者中，对问卷进行了 3 次迭代，同时还对 7 天加速度计和 RPAQ 测量进行了评估。在第 3 阶段，在 523 名 CKD 患者中，将确定的 CKD-PAQ 与 RPAQ 进行了比较。
在第 2 阶段的最后一次迭代中，在 60 名患者中比较了 CKD-PAQ 数据与加速度计衍生数据和 RPAQ 数据。所有方法的平均每日代谢当量任务（MET）和总能量消耗（TEE）水平相似。组内相关系数表明，加速度计与 CKD-PAQ 和 RPAQ 之间的一致性为中等（MET）和良好（TEE）。问卷之间的一致性非常好。CKD-PAQ 的平均（标准偏差（SD））每日 MET 偏差为 0.035（0.312），RPAQ 的平均（SD）为 0.018（0.326）。CKD-PAQ 的平均（SD）TEE 偏差为 91（518），RPAQ 的平均（SD）为 44（548）千卡。两个参数的 LOA 都很宽，CKD-PAQ 值的分散度较小。在第 3 阶段，问卷之间的一致性很好（MET）和非常好（TEE）。CKD-PAQ 衍生的平均（SD）每日 MET 与 RPAQ 衍生值的偏差为 0.031（0.193），95%LOA 为 -0.346 至 0.409。相应的 TEE 平均值（SD）为 48（325）和 -588 至 685 千卡/天。CKD-PAQ 似乎改善了低活动组之间的区分度。
尽管 CKD-PAQ 比 RPAQ 更短、更容易完成，并且可能更好地捕获低水平活动并改善低活动组之间的区分度，但它的性能与 RPAQ 相当。
