Physician knowledge, attitudes, and practices regarding physical activity restrictions in pediatric hemodialysis patients

Authors

Raja Dandamudi, Department of Pediatrics, Washington University School of Medicine, St. Louis, Missouri, USA.
Katherine Twombley, Department of Pediatrics, Division of Pediatric Nephrology, Medical University of South Carolina, Charleston, South Carolina, USA.
Joseph T. Flynn, Division of Nephrology, Department of Pediatrics, University of Washington and Seattle Children's Hospital, Seattle, Washington, USA.
Aadil Kakajiwala, Division of Nephrology, Department of Pediatrics, Children's National Hospital, The George Washington University School of Medicine and Health Sciences, Washington, DC, USA.
Deepa H. Chand, Novartis Pharmaceuticals, Bannockburn, Illinois, USA.

Document Type

Journal Article

Publication Date

10-1-2023

Journal

Hemodialysis international. International Symposium on Home Hemodialysis

Volume

27

Issue

4

DOI

10.1111/hdi.13095

Keywords

access; daily dialysis; pediatrics

Abstract

INTRODUCTION: Epidemiologic studies of physical activity among pediatric hemodialysis (HD) patients are lacking. A sedentary lifestyle in End-Stage Kidney Disease is associated with a higher cardiovascular mortality risk. In those patients receiving HD, time spent on dialysis and restrictions on physical activity due to access also contribute. No consensus exists regarding physical activity restrictions based on vascular access type. The aim of this study was to describe the patterns of physical activity restrictions imposed by pediatric nephrologists on pediatric HD patients and to understand the basis for these restrictions. METHODS: We conducted a cross-sectional study involving US pediatric nephrologists using an anonymized survey through Pediatric Nephrology Research Consortium. The survey consisted of 19 items, 6 questions detailed physician characteristics with the subsequent 13 addressing physical activity restrictions. FINDINGS: A total of 35 responses (35% response rate) were received. The average years in practice after fellowship was 11.5 years. Significant restrictions were placed on physical activity and water exposure. None of the participants reported accesses damage or loss that was attributed to physical activity and sport participation. Physicians practice is based on their personal experience, standard practice at their HD center, and clinical practices they were taught. DISCUSSION: There is no consensus among pediatric nephrologists about allowable physical activity in children receiving HD. Due to the lack of objective data, individual physician beliefs have been utilized to restrict activities in the absence of any deleterious effects to accesses. This survey clearly demonstrates the need for more prospective and detailed studies to develop guidelines regarding physical activity and dialysis access in order to optimize quality of care in these children.

APA Citation

Dandamudi, Raja; Twombley, Katherine; Flynn, Joseph T.; Kakajiwala, Aadil; and Chand, Deepa H., "Physician knowledge, attitudes, and practices regarding physical activity restrictions in pediatric hemodialysis patients" (2023). GW Authored Works. Paper 3703.
https://hsrc.himmelfarb.gwu.edu/gwhpubs/3703

Department

Pediatrics