Christensen Jesse C, Anand Shuchi, Chertow Glenn M, Lyden Kate, Sarwal Amara, Bjordahl Terrence, Boucher Robert, Mohammed Azeem, Oro Evan G, Akramimoghaddam Farahnaz, Katkam Niharika, Takyi Augustine, Bissada George, Chakravartula Akhil Ramanujam, Lee Edison, Zheng Ann, Wei Guo, Greene Tom, Beddhu Srinivasan
Department of Physical Therapy & Athletic Training, University of Utah, College of Health, Salt Lake City, UT, USA; Physical Medicine and Rehabilitation, Veterans Affairs Salt Lake City Health Care System, Salt Lake City, UT, USA.
Division of Nephrology, Department of Medicine, Stanford University School of Medicine, Stanford, CA, USA.
Contemp Clin Trials. 2025 Feb;149:107766. doi: 10.1016/j.cct.2024.107766. Epub 2024 Nov 26.
Sedentary behavior is highly prevalent and associated with morbidity and mortality in chronic kidney disease (CKD). A Sit Less, Interact and Move More (SLIMM) sedentary activity coaching intervention can reduce sedentary duration among persons with CKD, but preliminary data suggest that effects may not persist. Prior studies have suggested that moderate/vigorous intensity physical activities are not sustainable in persons with CKD. Therefore, we aimed to determine whether guided resistance training ± oral semaglutide co-intervention improves adherence and/or persistence of the SLIMM intervention.
METHOD/DESIGN: The SLIMM-2 is a two-center study designed with a 3-month sedentary activity coaching (SLIMM) followed by a 9-month randomized controlled trial with three arms: SLIMM + standard of care resistance training + oral placebo, SLIMM + guided resistance training + oral placebo, or SLIMM + guided resistance training + oral semaglutide. The study is recruiting persons with CKD (eGFR 20 to ≤60 ml/min/1.73 m). ActivPAL, a wearable tri-axial accelerometer, is used to assess outcomes including sedentary duration (primary outcome), stepping duration and the average number of steps per day. Additional outcomes include 6-min walk distance and body fat percentage. Persons randomized to standard of care resistance training will be encouraged to maintain individualized physical activity goals; those randomized to guided resistance training will attend guided sessions per month and be prescribed daily independent exercises.
Enrollment, interventions, and follow-up are ongoing.
Results from the SLIMM-2 study are expected to inform clinical practice, with the potential to enhance physical health and functioning among persons with CKD.
久坐行为在慢性肾脏病（CKD）中极为普遍，且与发病率和死亡率相关。“少坐、互动并多动（SLIMM）”久坐活动指导干预可减少CKD患者的久坐时间，但初步数据表明效果可能无法持续。先前的研究表明，中/高强度体育活动对CKD患者而言难以持续。因此，我们旨在确定指导性抗阻训练±口服司美格鲁肽联合干预是否能提高SLIMM干预的依从性和/或持续性。
方法/设计：SLIMM - 2是一项双中心研究，设计为先进行为期3个月的久坐活动指导（SLIMM），随后是为期9个月的随机对照试验，分为三组：SLIMM + 标准护理抗阻训练 + 口服安慰剂、SLIMM + 指导性抗阻训练 + 口服安慰剂或SLIMM + 指导性抗阻训练 + 口服司美格鲁肽。该研究正在招募CKD患者（估算肾小球滤过率[eGFR]为20至≤60 ml/min/1.73 m²）。使用可穿戴三轴加速度计ActivPAL评估结果，包括久坐时间（主要结果）、步行时间和每日平均步数。其他结果包括6分钟步行距离和体脂百分比。随机分配到标准护理抗阻训练组的患者将被鼓励维持个性化体育活动目标；随机分配到指导性抗阻训练组的患者将每月参加指导课程，并被安排每日独立锻炼。
入组、干预和随访正在进行中。
预计SLIMM - 2研究的结果将为临床实践提供参考，有可能改善CKD患者的身体健康和功能。
