The Physical Evaluation and Adverse outcomes for patients with chronic Kidney disease in Guangdong (PEAKING) project: a protocol and overview for a prospective cohort study

Introduction: Physical inactivity is prevalent and associated with adverse outcomes among patients with chronic kidney disease (CKD). Most previous studies have relied on subjective questionnaires to assess levels of physical activity (PA), and mainly focused on patients on dialysis. Therefore, the PEAKING study aims to investigate the levels and types of PA such as traditional Chinese exercise (TCE) and their association with adverse outcomes in Chinese non-dialysis CKD (ND-CKD) stage 3–5 patients. Methods and analysis: In this prospective cohort study, 374 ND-CKD stage 3–5 patients will be recruited in Guangdong province, South China. The primary exposure is levels of PA assessed by Actigraph GT3X + accelerometer including the intensity, duration, frequency, and types of PA. The primary outcomes are all-cause mortality and all-cause hospitalization. Other variables include demographics, comorbidities, medication, laboratory markers etc,. will be collected. All data will be updated annually for 5 years, or until the occurrence of death or initiation of renal replacement therapy. Preliminary results: Among 104 patients (57 ± 14 years; men 57%) with ND-CKD stage3-5 enrolled so far [stage 3 (55.8%), stage 4 (22.1%), and stage 5 (22.1%)], more than half of them (n = 62) achieveed at least 150 minutes of moderate-intensity PA per week and slightly outnumbered non-achievers (n = 42), indicating a relatively balanced distribution. Conclusions In this the first investigation of the relationship between exposure to PA including TCE and outcomes, the feasibility of the study including collection of data according to protocol was confirmed.