Department of Kinesiology, University of Massachusetts, Amherst, Massachusetts.
Department of Health and Exercise Science, Colorado State University, Fort Collins, Colorado.
Clin J Am Soc Nephrol. 2021 May 8;16(5):717-726. doi: 10.2215/CJN.12300720. Epub 2021 Apr 22.
We tested the feasibility of reducing sedentary behavior common in CKD.
DESIGN, SETTING, PARTICIPANTS, & MEASUREMENTS: We carried out a Sit Less, Interact, Move More intervention in a 24-week parallel-group, randomized controlled trial in patients with stages 2-5 CKD. In the intervention group (=54), accelerometry performed at baseline and repeated every 4 weeks was used to develop and monitor adherence to individualized plans targeting sedentary and stepping durations. The control group (=52) was provided national physical activity recommendations; accelerometry was performed at baseline and every 8 weeks. Between-groups changes from baseline to the average follow-up values at weeks 8, 16, and 24 of the sedentary and stepping durations were the coprimary end points.
The mean age was 69±13 years. Fourteen percent were on dialysis or received a kidney transplant. Eight percent of the control group and 17% of the intervention group were lost to follow-up. Sedentary and stepping durations did not change in the control group. Within the intervention group, the maximum decrease in sedentary duration (-43; 95% confidence interval, -69 to -17 min/d) and increase in stepping duration (16; 95% confidence interval, 7 to 24 min/d) and the number of steps per day (1265; 95% confidence interval, 518 to 2012) were seen at week 20. These attenuated at week 24. In mixed effects models, overall treatment effects between groups on sedentary (-17; 95% confidence interval, -43 to 8 min/d) and stepping (6; 95% confidence interval, -3 to 15 min/d) durations and the number of steps per day, a secondary end point (652; 95% confidence interval, -146 to 1449), were not significantly different. The intervention significantly reduced secondary end points of body mass index (-1.1; 95% confidence interval, -1.9 to -0.3 kg/m) and body fat percentage (-2.1%; 95% confidence interval, -4.4% to -0.2%).
It is feasible to reduce sedentary duration and increase stepping duration in patients with CKD, but these were not sustained.
National Health and Nutrition Examination Survey (NHANES), NCT02970123.
我们检验了减少慢性肾脏病（CKD）患者常见久坐行为的可行性。
设计、设置、参与者和测量：我们在一项为期 24 周的 2 期 CKD 患者平行组随机对照试验中开展了 Sit Less, Interact, Move More 干预。在干预组（n=54）中，使用基线时和每 4 周重复一次的加速度计来制定和监测针对久坐和步数时长的个体化计划的依从性。对照组（n=52）接受了国家体育活动建议；在基线和每 8 周进行加速度计测量。主要结局是组间从基线到 8 周、16 周和 24 周时久坐和步数时长的平均随访值的变化。
患者平均年龄为 69±13 岁，14%的患者正在接受透析或肾移植。对照组和干预组分别有 8%和 17%的患者失访。对照组的久坐和步数时长未发生变化。干预组中，最大的久坐时间减少（-43；95%置信区间，-69 至 -17 分钟/天）和步数增加（16；95%置信区间，7 至 24 分钟/天）以及每天步数（1265；95%置信区间，518 至 2012）发生在第 20 周。这些变化在第 24 周时减弱。在混合效应模型中，组间整体治疗效果在久坐时间（-17；95%置信区间，-43 至 8 分钟/天）和步数（6；95%置信区间，-3 至 15 分钟/天）以及次要结局（每日步数，652；95%置信区间，-146 至 1449）方面无显著差异。干预显著降低了体重指数（-1.1；95%置信区间，-1.9 至 -0.3 kg/m2）和体脂百分比（-2.1%；95%置信区间，-4.4%至 -0.2%）这两个次要结局。
减少 CKD 患者的久坐时间和增加步数是可行的，但这些效果不能持续。
美国国家健康和营养调查（NHANES），NCT02970123。
