Introduction and Background
Many persons with kidney disease do not meet physical activity guidelines. Based on findings that hospital-based group exercise programs can reduce fears and increase exercise self-efficacy, and a survey supporting patient’s desire for this programming, a Renal Nordic walking (NW) program at St Paul’s Hospital was developed. Working with a Patient Partner throughout the phases from design to dissemination, this study investigated the effects of a 3-month supervised Renal NW program on the fitness and quality of life of renal outpatients. 

Methods
Thirty participants, aged 45-84 were randomized to NW (n=15) or non-NW (n=15) groups. The NW group was offered 2 supervised NW sessions/week; the non-NW group continued their own activities. Outcome measurements at baseline and 3-month included weight, handgrip strength (HGS), 30-sec sit-to-stand test, 6-min walk test (6MWT), and Kidney Disease and Quality of Life questionnaire (KDQOL-36). Daily steps were recorded using Fitbit. Median changes in outcomes from baseline to 3-months were calculated between groups.

Results/Findings
Participants included post-renal transplant (n=10), pre-dialysis (n=14), hemodialysis (n=3), and peritoneal dialysis (n=3) patients. The NW group appeared less healthy compared to the non-NW group at baseline. However, the NW group had greater improvements in KDQOL-36 (Effect of kidney disease; p=0.021), 6MWT distance (41.5m), and HGS (1.1kg) at 3-month.

Discussion/Implications
A 41.5m improvement in 6MWT achieved in the NW group exceeded the Minimal Clinically Important Difference of 14.0–30.5m. Although a greater number of participants is needed to confirm these findings more confidently, these encouraging results indicate that a group-based supervised Renal NW program may provide meaningful benefits to renal outpatients. The program is now adopted by the hospital.

Dissemination Plan/KT Approach
Key messages were/are being shared via newsletters (i.e., allied health associations, Providence Health Care Communications internally & externally), general and targeted social media, Urban Poling, BC Renal Agency, Kidney Foundation of Canada, and conference abstracts and presentations.

Effects of a Renal Nordic Walking Program on Quality of Life and Fitness in renal patients: A Randomized Controlled Trial