Comparisons of In-Clinic and Free-Living Measures of Physical Function in Predicting Hospitalization in Patients with CKD

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Background: Physical function is associated with risk of hospitalization; however, comparisons of in-clinic and free-living measures of physical function and their associations with risk of hospitalization has not been well established. Methods: In this secondary analysis of the Sit Less, Interact, Move More (SLIMM) pilot study, we compared in clinic and free-living measures using accelerometry data. Participants with CKD were randomized to the SLIMM intervention or standard of care and asked to wear a thigh worn accelerometer 7 days before a visit to capture their physical activity. In clinic measures of physical function like 6-minute walk distance were performed during visits. Free-living measures were determined from accelerometry. Free-living 6-minute steps were defined as the number of steps taken during the most active recorded 6-minute period. Free-living measures of physical function were compared to in clinic measures using cox proportional hazards models adjusted for age, sex, smoking, alcohol use, BMI, diabetes, CKD, hypertension, heart failure, and peripheral vascular disease. Results: 106 participants were randomized, the mean age was 69 ± 12 and 69 ± 14, baseline eGFR was 44 ± 12 and 45 ± 14, and 48% and 37% were female for the standard of care and SLIMM groups respectively. When adjusted for covariates, both in clinic and free-living 6-minute walk distance and steps respectively were associated with hospitalizations (table). In comparisons between in clinic and free-living measures, in clinic measures were not significantly associated with hospitalizations while free-living measures were (table). Conclusions: Both in clinic and free-living measures of physical function were predictors of hospitalization in patients with CKD. Funding: NIDDK Support, Other NIH Support - NHLBI, Veterans Affairs Support Adjusted cox proportional hazard model for hospitalization in in clinic and free-living 6-minute walk

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