A Study of Wrist Worn Accelerometers in End-Stage Renal Disease

Study Overview
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Brief Summary
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The kidneys are important at getting rid of toxins and excess water from the body. If they fail, then toxins and excess water builds up within the body. Kidney failure is treated by either giving patients a new kidney (a transplant) or by removing the toxins and fluid from the body by the process of dialysis. The investigators' aim is to personalise the care given to patients with kidney failure, and as such, they have started measuring the fitness of patients with kidney failure, who either already require dialysis or may need dialysis in the near future. This is currently done in a number of ways including measuring how strong their grip is, assessing their walking speed and asking questions about how difficult they find certain activities. In the future, the investigators think that this will allow targeted treatments to help improve their fitness and potentially identify any problems earlier. Current approaches to measuring activity and fitness have limitations and in particular may over- or underestimate the level of the physical activity. To over come these limitations, participants will be asked to wear an activity tracker (called an accelerometer) on for a week. Readings from the accelerometer will be compared against the other markers of fitness and activity to see if they are comparable. It will also be noted whether patients are prepared to wear the device for 7 days (compliance).

Official Title
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A Feasibility Study of a Wrist Worn Accelerometer to Characterise the Physical Activity of Patients With End-stage Renal Disease (W-WARD Study).

Conditions
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Chronic Kidney Diseases, Frailty, End Stage Renal Disease on Dialysis

Intervention / Treatment
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* Device: GeneActiv wrist worn accelerometer


Participation Criteria
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Eligibility Criteria
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Inclusion Criteria: Aged over 18 years with low clearance pre-dialysis and referred to the Low Clearance Clinic with estimated Glomerular Filtration Rate (eGFR) less than 20 ml/min/1.73m and / or commenced on haemodialysis Able to give informed consent Exclusion Criteria: Significant resting tremor of any aetiology or severe Parkinson's Disease Immobile Arteriovenous fistulas in both arms Any scheduled inpatient treatment or day case treatment in next 7 days.

Ages Eligible for Study
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Minimum Age: 18 Years

Sexes Eligible for Study
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All

Accepts Healthy Volunteers
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No

Study Plan
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How is the study designed?
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Arms and Interventions

| Participant Group/Arm | Intervention/Treatment |
| --- | --- |
| End-Stage Renal Disease on haemodialysis<br>Wearing accelerometer (fitness tracker) for 7 days. | Device: GeneActiv wrist worn accelerometer<br>* Wrist worn device worn for 7 days<br>|
| Low clearance pre-dialysis patients<br>Wearing accelerometer (fitness tracker) for 7 days. | Device: GeneActiv wrist worn accelerometer<br>* Wrist worn device worn for 7 days<br>|

What is the study measuring?
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Primary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Acceptability | The acceptability of physical activity measures in frailty assessment in patients from the low clearance and dialysis clinic as determined by the percentage of time, device worn during the 7-day period. | 7 days | 

Secondary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Measurement of physical activity by the accelerometer | Measurement of physical activity by the accelerometer (no units) | 7 days | 
| Fried Frailty Phenotype (no units) | Fried Frailty Phenotype (no units) | 1 day | 
| Grip strength (in kilograms) | Grip strength (in kilograms) | 1 day | 
| Walking speed (in seconds measured over 15 feet) | Walking speed (in seconds measured over 15 feet) | 1 day | 
| Clinical Frailty Scale (no units) | Clinical Frailty Scale (no units) | 1 day | 
| 10 Point Cognitive Screener (no units) | 10 Point Cognitive Screener (no units) | 1 day | 
| 4AT Assessment Tool of Cognitive Impairment (no units) | 4AT Assessment Tool of Cognitive Impairment (no units) | 1 day |