Making the case for standardized outcome measures in exercise and physical activity research in chronic kidney disease

Physical activity and exercise are core components of lifestyle modification strategies for the management of chronic kidney disease (CKD). Yet, physical activity levels have consistently remained poor across all stages of CKD. Exercise interventions, including aerobic and resistance training, and lifestyle interventions promoting physical activity, have been shown to improve a multitude of clinical endpoints and factors important to patients; however, despite the evidence, the provision of physical activity in clinical practice is still inadequate. The usefulness of any study hinges on the adequacy and clinical relevance of the outcomes and outcome measures used. Inconsistent reporting and wide disparities in outcome use across studies limit evidence synthesis to help guide clinical practice. The kidney exercise and physical activity field has been particularly prone to inconsistent outcome reporting. To ensure research is relevant and able to influence clinical practice and future research, we need to ensure the use (and reporting) of standardized, relevant outcome measures. Core outcome sets (COS) have been widely developed across many chronic conditions, yet these COS have not been tailored to physical activity and exercise in CKD. Outcomes in clinical research need to be relevant to the intervention being employed. From this perspective, we summarize the importance that standardizing outcomes and outcome measures may have in relation to physical activity and exercise interventions for people living with kidney disease.</p

Additional file 1: Table S1. of Prevalence of frailty in Canadians 18–79 years old in the Canadian Health Measures Survey

Components of the frailty index and how they are scored. Table S2. Components of the Fried frailty components and how they are scored. Table S3. Comparison of health-deficits across Canadian Health Measures Cycles. (DOCX 17 kb

sj-docx-1-cjk-10.1177_20543581231162218 – Supplemental material for Magnitude of the Potential Screening Gap for Fabry Disease in Manitoba: A Population-Based Retrospective Cohort Study

Supplemental material, sj-docx-1-cjk-10.1177_20543581231162218 for Magnitude of the Potential Screening Gap for Fabry Disease in Manitoba: A Population-Based Retrospective Cohort Study by Reid H. Whitlock, Mohammad Nour-Mohammadi, Sarah Curtis, Paul Komenda, Clara Bohm, David Collister, Navdeep Tangri and Claudio Rigatto in Canadian Journal of Kidney Health and Disease</p

Measurement properties of performance-based measures to assess physical function in chronic kidney disease: recommendations from a COSMIN systematic review

Background There is wide heterogeneity in physical function tests available for clinical and research use, hindering our ability to synthesize evidence. The aim of this review was to identify and evaluate physical function measures that could be recommended for standardized use in chronic kidney disease (CKD). Methods MEDLINE, EMBASE, Cochrane Central Register of Controlled Trials, Cochrane Database of Systematic Reviews, CINAHL, Scopus and Web of Science were searched from inception to March 2022, identifying studies that evaluated a clinimetric property (validity, reliability, measurement error and/or responsiveness) of an objectively measured performance-based physical function outcomes using the COnsensus-based Standards for the selection of health Measurement Instruments (COSMIN) methodology and Grading of Recommendations, Assessment, Development, and Evaluations (GRADE) based recommendations. Studies with individuals of all ages and of any stage of CKD were included. Results In total, 50 studies with 21 315 participants were included. Clinimetric properties were reported for 22 different physical function tests. The short physical performance battery (SPPB), Timed-up-and-go (TUG) test and Sit-to-stand tests (STS-5 and STS-60) had favorable properties to support their use in CKD and should be integrated into routine use. However, the majority of studies were conducted in the hemodialysis population, and very few provided information regarding validity or reliability. Conclusion The SPPB demonstrated the highest quality of evidence for reliability, measurement error and construct validity amongst transplant, CKD and dialysis patients. This review is an important step towards standardizing a core outcome set of tools to measure physical function in research and clinical settings for the CKD population.</p

sj-docx-2-cjk-10.1177_20543581221150676 – Supplemental material for Development and Validation of Patient Education Tools for Deprescribing in Patients on Hemodialysis

Supplemental material, sj-docx-2-cjk-10.1177_20543581221150676 for Development and Validation of Patient Education Tools for Deprescribing in Patients on Hemodialysis by Thomas Hyunwoo Cho, Patrick C. K. Ng, Melissa J. Lefebvre, Arlene Desjarlais, Dennis McCann, Blair Waldvogel, Marcello Tonelli, Amit X. Garg, JoAnne Wilson, Monica Beaulieu, Judith Marin, Cali Orsulak, Melanie Talson, Monica Sharma, Jordanne Feldberg, Clara Bohm and Marisa Battistella in Canadian Journal of Kidney Health and Disease</p