MRC Epidemiology UnitWhat did we hope to find out in the W-WARD study?
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. We treat kidney failure by either giving patients a new kidney (a transplant) or by removing the toxins and fluid from the body by the process of dialysis.
There is a need to personalise the care given to patients with kidney failure. We have recently started measuring the physical function and activity levels of patients at Cambridge University Hospitals NHS Foundation Trust with kidney failure, who either already require dialysis or may need dialysis in the near future. We are currently doing this 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, we think this additional information about a patient’s function will allow us to target treatments to help improve functional ability and potentially identify any problems earlier.
We are aware that our current approach to measuring physical activity by a self-report questionnaire has limitations, and in particular may over- or underestimate the patient’s actual level of the physical activity. For this reason, we were keen to see if we can get a better measurement of levels of activity by asking patients to wear an activity monitor (called an accelerometer) on their wrist at home for a week doing their usual activities and repeat this 6 months later. We compared the information from the accelerometer against the other measurements of physical activity and physical function we routinely measure and see if they are comparable and whether in the future this measure could be used to identify people who may be at risk of being frail and need extra support.
What did taking part in the study involve?
Participants were asked to wear an activity monitor continuously on their wrist for 7 days. They were shown how to wear the monitor by a member of the direct care or research team and given instructions to take home about the monitor. At the end of 7-days, they were asked to return the device either back at their next clinic appointment or return in a pre-paid envelope. Participants were asked to wear this monitor a second time 6 months after their first wear.
Who can take part?
Recruitment for the study is now closed.
Patients on dialysis or attending the pre-dialysis clinic at Addenbrookes Hospital were asked if they would like to take part in the study if they meet the inclusion and exclusion criteria.