Documented Physical Activity Discussions in Children With Chronic Kidney Disease-An Analysis of Patient- and Clinician-Level Variables.

PURPOSE: We investigated the prevalence of documented physical activity (PA) participation and recommendations among pediatric nephrologists and identified disease-related variables that predicted which patients received PA recommendations.

METHOD: Patient charts were reviewed for children 3-18 years old, and data were extracted for those with international classification of disease 10 codes N18 (chronic kidney disease) or Z94.0 (kidney transplant). Demographic data, documented PA participation and recommendations, and disease variables were abstracted.

RESULTS

Of 404 patients (64% male; 12.4 [4.0]) with estimated glomerular filtration rate of 67.8 (30.9) mL/min/1.73 m2; 239 (59.2%) had documented PA participation, and 119 (29.6%) had a documented PA recommendation in their chart. PA recommendations were more likely in older patients (odds ratio [OR]: 1.08; 95% CI, 1.03-1.13), those with higher body mass index z score (OR: 1.45; 95% CI, 0.96-1.51), higher height z score (OR: 1.55; 95% CI, 1.31-1.82), higher estimated glomerular filtration rate (OR: 1.01; 95% CI, 1.01-1.02), sport participation (OR: 2.47; 95% CI, 1.46-4.19), and less likely for patients with higher motor score (OR: 0.6; 95% CI, 0.41-0.87; all P < .01). Adjusted analysis maintained significant associations except sports participation and motor score.

CONCLUSION

A low proportion of children with chronic kidney disease, who are at risk of physical inactivity, received PA recommendations to increase PA. Recommendations were more likely in older, overweight, taller, better kidney function, and sport participants. Effect sizes were small or moderate; further study is needed.