Skeletal and Respiratory Muscle Strength, Pulmonary Function, Exercise Capacity and Physical Activity in Pediatric Chronic Kidney Disease
Condition: Chronic Kidney Diseases
MeSH terms: Kidney Diseases; Renal Insufficiency, Chronic
Study type: Observational

Summary: 
      Studies examining musculoskeletal strength, respiratory function and muscle strength,
      physical activity level and exercise capacity in children with CKD and evaluating the
      relationships between these parameters have not been found both in the world and in our
      country. In this study, it is aimed to evaluate skeletal and respiratory muscle strength,
      respiratory parameters and exercise capacity in children with CKD primarily and compare them
      with healthy children. Secondly, it is to examine the relationship between endothelial
      function, arterial stiffness, sarcopenia and physical activity in children with CKD. It is
      thought that the results to be obtained with the study will support the literature with the
      prediction that rehabilitation programs for patients in all stages of CKD will be structured
      and in this way will contribute positively to the management and prognosis of the disease.

      Hypotheses H0: There is no difference between children with chronic kidney disease and
      healthy children in terms of skeletal and respiratory muscle strength, respiratory parameters
      and exercise capacity.

      H1: There is a difference between children with chronic kidney disease and healthy children
      in terms of skeletal and respiratory muscle strength, parameters and exercise capacity.

      H0: There is no relationship between endothelial function, arterial stiffness, sarcopenia and
      physical activity in children with chronic kidney disease.

      H1: There is a relationship between endothelial function, arterial stiffness, sarcopenia and
      physical activity in children with chronic kidney disease.
    

Detailed description: 
      Children who applied to Gazi University, Faculty of Medicine, Department of Pediatrics,
      Department of Pediatric Nephrology and met the specified inclusion criteria will be included
      in our study. Patients will be referred to Hacettepe University, Faculty of Physical Therapy
      and Rehabilitation, Department of Physiotherapy and Rehabilitation, Cardiopulmonary
      Rehabilitation Unit after the routine evaluations including demographic and clinical
      characteristics, laboratory tests and anthropometric measurements are completed. Here,
      patients will be evaluated with physical therapy and rehabilitation measurement and
      evaluation methods such as muscle strength, exercise capacity and physical activity. The
      healthy control group will be formed by inviting the healthy relatives of the patients who
      applied to our faculty to participate in the study. After obtaining informed consent, healthy
      children will be evaluated.

      Details of Working Method For each child with chronic kidney disease, age, gender, body
      weight, height, systolic and diastolic blood pressure, and results of routine blood tests
      (complete blood count test parameters: hemoglobin, hematocrit, erythrocyte, leukocyte and
      platelet count) biochemistry test parameters (blood sugar, blood urea nitrogen, creatinine,
      uric acid, sodium, potassium, chlorine, calcium, phosphorus, alkaline phosphatase, total
      protein, albumin, alanine aminotransferase, aspartate aminotransferase, triglyceride, total
      cholesterol, high-density lipoprotein, low-density lipoprotein levels , venous blood pH and
      bicarbonate etc. values), ferritin, parathormone, 25 hydroxy vitamin D level) will be
      recorded. The age at diagnosis, duration and etiology of the disease, current treatment
      information and drugs used will be recorded. Body composition data will also be recorded for
      children with CKD. Bone mineral density parameters in the last six months, left ventricular
      mass index values in the last three months, 24-hour blood pressure monitoring (ABPM) in the
      last month, and heart rate measured on the same device are used in the follow-up of the
      patients. wave velocity (pulse wave velocity-PWV) evaluation results will be used, if there
      is none, ABPM and PWV will be performed again. After these evaluations, parameters such as
      skeletal muscle strength, respiratory muscle strength, and exercise capacity will be
      evaluated in both the patient group and healthy children, and the obtained data will be
      compared. In addition, the relationship between parameters such as complete blood count
      parameters, biochemistry test parameters, routine bone markers, BMD, heart and vascular
      function evaluations and parameters such as skeletal and respiratory muscle strength,
      exercise capacity, and physical activity level will be examined in children with CKD. In case
      of adequate data, children with CKD will be subgrouped according to disease stage and
      assessment data will be analyzed by subgroups.
    

Intervention name(s): Assessments parameters
Intervention type(s): Other
Intervention description(s): Demographic and Clinical Characteristics, Bone Mineral Density, Sarcopenia, Body Composition, Arterial Stiffness, Endothelial Function, Echocardiography,Pulmonary Function, Respiratory Muscle Strength, Submaximal exercise capacity, Maximal Exercise Capacity, Physical Activity Level, Hand Grip Strength, Lower Extremity Muscle Strength
Observational model: Case-Control
Time perspective: Prospective
Sampling method: Non-Probability Sample
Study population: 
        Children who applied to Gazi University, Faculty of Medicine, Department of Pediatrics,
        Department of Pediatric Nephrology and met the specified inclusion criteria will be
        included in our study. Patients will be referred to Hacettepe University, Faculty of
        Physical Therapy and Rehabilitation, Department of Physiotherapy and Rehabilitation,
        Cardiopulmonary Rehabilitation Unit after the routine evaluations including demographic and
        clinical characteristics, laboratory tests and anthropometric measurements are completed.
        Here, patients will be evaluated with physical therapy and rehabilitation measurement and
        evaluation methods such as muscle strength, exercise capacity and physical activity. The
        healthy control group will be formed by inviting the healthy relatives of the patients who
        applied to our faculty to participate in the study. After obtaining informed consent,
        healthy children will be evaluated.