Related Experiment Video
Updated: Sep 13, 2025
Assessment of Vascular Function in Patients With Chronic Kidney Disease
Published on: June 16, 2014
Documented Physical Activity Discussions in Children With Chronic Kidney Disease-An Analysis of Patient- and
Molly Wong Vega1,2, Ayse Akcan-Arikan1,3, Kristofer Jennings4
1Division of Nephrology, Department of Pediatrics, Baylor College of Medicine, Houston, TX,USA.
Insights
Pediatric nephrologists infrequently recommended physical activity (PA) for children with chronic kidney disease. Recommendations were more common in older, overweight, and taller children with better kidney function.
Area of Science:
- Pediatric Nephrology
- Public Health
- Exercise Science
Background:
- Children with chronic kidney disease (CKD) are at increased risk of physical inactivity.
- Promoting physical activity (PA) is crucial for managing CKD in pediatric populations.
- Understanding current PA recommendation practices is essential for improving patient care.
Purpose of the Study:
- To determine the prevalence of documented physical activity (PA) participation and recommendations among pediatric nephrologists.
- To identify disease-related variables that predict which pediatric CKD patients receive PA recommendations.
Main Methods:
- Retrospective chart review of 404 children aged 3-18 years with CKD (ICD-10 code N18) or kidney transplant (Z94.0).
- Data abstracted included demographics, documented PA participation and recommendations, and disease variables.
- Statistical analysis, including odds ratios (OR) and 95% confidence intervals (CI), was used to identify predictors of PA recommendations.
Main Results:
- Only 29.6% of pediatric CKD patients had a documented PA recommendation.
- PA recommendations were more likely in older patients (OR: 1.08), those with higher BMI z-score (OR: 1.45), higher height z-score (OR: 1.55), and better estimated glomerular filtration rate (eGFR) (OR: 1.01).
- Patients participating in sports (OR: 2.47) were more likely to receive recommendations, while those with higher motor scores were less likely (OR: 0.6).
Conclusions:
- A low proportion of children with CKD receive crucial PA recommendations, despite their increased risk of inactivity.
- PA recommendations were associated with older age, overweight status, taller stature, better kidney function, and sports participation.
- Further research is needed to enhance PA promotion in pediatric CKD management, as observed effect sizes were small to moderate.
Purpose:
We investigated the prevalence of documented physical activity (PA) participation and recommendations among pediatric nephrologists and identified disease-related variables that predicted which patients received PA recommendations.
Method:
Patient charts were reviewed for children 3-18 years old, and data were extracted for those with international classification of disease 10 codes N18 (chronic kidney disease) or Z94.0 (kidney transplant). Demographic data, documented PA participation and recommendations, and disease variables were abstracted.
Results:
Of 404 patients (64% male; 12.4 [4.0]) with estimated glomerular filtration rate of 67.8 (30.9) mL/min/1.73 m2; 239 (59.2%) had documented PA participation, and 119 (29.6%) had a documented PA recommendation in their chart. PA recommendations were more likely in older patients (odds ratio [OR]: 1.08; 95% CI, 1.03-1.13), those with higher body mass index z score (OR: 1.45; 95% CI, 0.96-1.51), higher height z score (OR: 1.55; 95% CI, 1.31-1.82), higher estimated glomerular filtration rate (OR: 1.01; 95% CI, 1.01-1.02), sport participation (OR: 2.47; 95% CI, 1.46-4.19), and less likely for patients with higher motor score (OR: 0.6; 95% CI, 0.41-0.87; all P < .01). Adjusted analysis maintained significant associations except sports participation and motor score.
Conclusion:
A low proportion of children with chronic kidney disease, who are at risk of physical inactivity, received PA recommendations to increase PA. Recommendations were more likely in older, overweight, taller, better kidney function, and sport participants. Effect sizes were small or moderate; further study is needed.
Related Concept Videos
01:28Chronic Kidney Disease III: Interprofessional Care
01:24Chronic Kidney Disease II: Clinical Manifestations
01:18Chronic Kidney Disease IV: Nursing Management
01:25Chronic Kidney Disease I: Introduction
01:17Factors Affecting Renal Clearance: Renal Impairment
One condition associated with renal failure is uremia. Uremia is characterized by impaired glomerular filtration and fluid accumulation in the body. This condition hinders the renal clearance of drugs, resulting in drug accumulation and potential...
01:20Acute Kidney Injury V: Interprofessional Care