Disclosures: The authors report no relevant financial disclosures.
July 15, 2021
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Fitness trackers did not indicate clinical deterioration among patients on dialysis

Disclosures: The authors report no relevant financial disclosures.
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Patients undergoing maintenance hemodialysis demonstrated a low, daily step count, a study in Kidney Medicine revealed. However, researchers found dialysis did not have a consistent effect on the number of steps taken.

“It is possible but untested that variations in a patient’s physical activity may serve as an ‘early warning’ of such progressive deterioration, triggering a detailed clinical assessment followed by a timely intervention and treatment,” author Marcello Tonelli, MD, SM, MSc, of the University of Calgary, and colleagues wrote.

older people exercising
Source: Adobe Stock

In a study conducted between June and October 2019, Tonelli and colleagues monitored the step count of 46 patients through Fitbit devices and the frequency of clinical events such as visits to the hospital or urgent care centers. Researchers also considered indicators of deterioration such as age, sex, BMI and other factors.

Participants came from outpatient hemodialysis clinics associated with the Southern Alberta Renal Program. Of the 46 patients, 63% were men and the mean age was 64 years. Eleven participants reported at least one clinical event throughout the duration of the study.

The study revealed “no clear relationship between the clinical events and the within-patient pattern in the number of daily steps,” and it is “less likely that activity trackers will be useful for predicting clinical deterioration,” Tonelli and colleagues wrote.

Researchers did observe an association between more steps and better performance and higher ambient temperatures. Advanced age and obesity were associated with fewer steps in a day, Tonelli and colleagues wrote.

Tonelli and colleagues observed that all patients had a relatively low number of steps, “perhaps reflecting the burden of age and comorbidity among contemporary hemodialysis patients.”

Some limitations to the study included the unpredictable step counts of participants, researchers noted. Tonelli and colleagues recommend using a rolling average to track steps and a longer study period for future studies. Also, researchers suggested current fitness trackers are somewhat limited in accuracy, possibly impeding the ability of researchers to test whether physical activity was a predictor of clinical deterioration.

“However, while step count metrics were not sufficient to develop a robust prediction algorithm, future research exploring the accuracy and predictive potential of other wearable technology metrics as the technology advance, may be useful to help answer this question,” Tonelli and colleagues wrote.