Change in Physical Activity and Function in Patients with Baseline Advanced Non-Dialysis CKD
Bibliographic record
Abstract
Background: Progressive declines in physical activity and function are common in individuals with worsening chronic kidney disease (CKD). However, little is known about whether the transition to dialysis is associated with accelerated decline. We aimed to assess temporal rates of change in physical activity level and physical function in people with advanced CKD to determine whether the transition to dialysis was associated with accelerated decline. Methods: Individuals with advanced CKD stages G4-G5 from the Canadian Frailty Observation and Interventions Trial (CanFIT) were included. Outcomes included change in physical activity level measured using the Physical Activity Scale for the Elderly (PASE) and physical function measured using the chair stand test, 4-meter gait speed, and grip strength. Unadjusted and adjusted generalized linear regression models were conducted to determine whether progression to dialysis was associated with greater decline in physical activity or physical function. Results: Of 386 individuals, 162 individuals progressed to dialysis during the study period, whereas 224 did not. Both groups experienced statistically significant declines in self-reported physical activity, increased chair stand test times, and decreased gait speed. Compared to individuals with advanced nondialysis CKD, progression to dialysis was associated with greater increase in chair stand test time in unadjusted (beta estimate 6.05 seconds, 95% CI 2.36 - 9.74, p=0.001) and adjusted (beta estimate 5.23 seconds, 95% CI 0.75 - 9.71, p=0.02) models. Conclusions: Although individuals with advanced CKD experience declines in physical activity and function over time, progression to dialysis is associated with accelerated decline in physical function as measured by the chair stand test. Future studies on interventions to delay or prevent declines associated with CKD progression and dialysis initiation are needed.
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How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.001 | 0.004 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.000 | 0.001 |
| Bibliometrics | 0.000 | 0.001 |
| Science and technology studies | 0.000 | 0.000 |
| Scholarly communication | 0.001 | 0.000 |
| Open science | 0.000 | 0.000 |
| Research integrity | 0.000 | 0.001 |
| Insufficient payload (model declined to judge) | 0.001 | 0.000 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".