Peak aerobic capacity from incremental shuttle walk test in chronic kidney disease.

BACKGROUND: Assessment of cardiorespiratory fitness is an important outcome in chronic kidney disease (CKD). We aimed to develop a predictive equation to estimate peak oxygen uptake (VO2peak ) and power output (WPeak ), as measured during a cardiopulmonary exercise test (CPET), from the distance walked (DW) during the incremental shuttle walk test (ISWT). METHODS: Thirty-six non-dialysing patients with CKD [17 male, age: 61 ± 12 years, eGFR: 25±7 ml/min/1.73 m2 , body mass index (BMI): 31 ± 6 kg/m2 ] carried out laboratory-based CPET on a cycle ergometer and ISWT on two separate occasions. RESULTS: Linear regression revealed that DW/BMI was a significant predictor of VO2Peak (r = 0.78) (VO2Peak (ml/min/kg) = [0.5688 × (DW/BMI) (m)] + 11.50). No difference (p = 0.66) between CPET VO2Peak (19.9 ± 5.5 ml/min/kg) and predicted VO2Peak (19.9 ± 4.3 ml/min/kg) was observed. DW multiplied by body mass (BM) was a significant predictor of WPeak (r = 0.80) [WPeak (W) = (0.0018 × (DW × BM)) + 50.47]. No difference (p = 0.97) between CPET WPeak (116.2 ± 38.9 W) and estimated WPeak (113.9 ± 30.1 W) was seen. CONCLUSION: The present study demonstrates that VO2Peak and WPeak can be accurately estimated using the DW during an ISWT in CKD populations

Selecting portable ankle/toe brachial pressure index systems for a peripheral arterial disease population screening programme: A systematic review, clinical evaluation exercise, and consensus process.

Objective To provide an overview of systems available for peripheral arterial disease (PAD) screening, together with respective accuracies and a clinical evaluation to identify a system suitable for use in a community screening programme. Methods A systematic review of the diagnostic accuracy of six ankle brachial pressure index (ABPI) and toe brachial pressure index (TBPI) devices deemed to be portable, which were Conformité Européenne (CE) marked, and were automated or semi-automated was carried out compared with gold standard handheld Doppler and duplex ultrasound. The devices were MESI-ABPI-MD, Huntleigh Dopplex Ability, Huntleigh ABPI and TBPI systems, Systoe TBPI system, and BlueDop. Seven databases (MEDLINE, EMBASE, Scopus, Web of Science, Cochrane Database of Systematic Reviews, Cochrane Register of Controlled Trials (CENTRAL), and Cumulative Index to Nursing and Allied Health Literature (CINAHL)) were searched, and 11 studies were identified as eligible for review. This was followed by hands on clinical evaluation by abdominal aortic aneurysm (AAA) screening staff (n = 39). During this, devices were demonstrated to staff which they then tested on volunteers and gave feedback using pre-designed questionnaires on their suitability for use in a screening programme. Finally, accuracy data and staff preferences were combined during a consensus conference that was held between study and screening staff to determine the most appropriate device to use in a community screening programme. Results Generally, the evaluated systems have a moderate level of sensitivity and a high level of specificity: Dopplex ability sensitivity 20% – 70%, specificity 86% – 96%; MESI sensitivity 57% – 74%, specificity 85% – 99%; BlueDop sensitivity 95%, specificity 89%; and Systoe sensitivity 71%, specificity 77%. Clinical evaluation by screening staff identified a preference for the MESI system. The consensus conference concluded that the MESI device was a good candidate for use in a community PAD screening programme. Conclusion The MESI system is a good candidate to consider for community PAD screening.</p