Pedometers to Assess and Increase Physical Activity Among Children With Chronic Kidney Disease

Hypothesis #1: Most children with CKD stages 2-4, ESRD and kidney transplantation will
report participation in physical activity that falls short of recommended levels of physical
activity; Children on dialysis will be less active.

Hypothesis #2: Patients will endorse many barriers to physical activity, some of which will
be related to their disease or its treatment; those who are less active will endorse more
barriers.

Hypothesis #3: Patients will increase their participation in physical activity in response
to a pedometer-based 12 week intervention.

Baseline level of physical activity and magnitude of increase in physical activity will be
more closely associated with change in physical functioning and performance than stage of
kidney disease or type of renal replacement therapy.

Exercise capacity of the child will be measured by the six minute walk test whereby the
subject will asked to walk as far as possible in 6 minutes in a straight corridor.

Body fat or body composition will then be measured by Bioelectric Impedance Spectroscopy.

Physical functioning or Health Related Quality of Life will be assessed self reported/
parent proxy reliable and validated questionnaire specifically designed for child with
chronic kidney disease called Pediatric Quality of Life Inventory (Peds QL 4.0). Subjects
(teens) or parents will also be asked to fill out a questionnaire on barriers to physical
activity on their first visit.

Physical activity will be measured in the form of daily steps. The child will wear the
pedometer for the first week to assess his/her baseline level of activity. Then the child
will continue to wear the pedometer for another 12 weeks during which time he or she will be
asked to gradually increase steps walked per day above baseline physical activity. The
patient will be called once a week in order to monitor progress, set new weekly step goals
(usually 500-1000 steps/day greater than the previous week), and motivate the participant.

After 12 weeks of the pedometer-based intervention to increase physical activity, physical
performance, body composition and physical functioning (as described above) will be measured
once again to assess the effect of increased physical activity on a second visit.