Investigating lifestyle determinants of muscle and physical function, and the impact on patient experience and support needs in kidney disease (DIMENSION-KD)
What is the purpose of the study?
Patients with kidney disease suffer from poor physical functioning, low levels of physical activity, and increased levels of disability. This makes doing everyday activities difficult and reduces their quality of life. Many public health recommendations emphasise the importance of a ‘healthy lifestyle’, however further research is needed to identify the important lifestyle factors impacted by kidney disease, as well as understanding the needs of the patient.
DIMENSION-KD aims to establish the effect and association of kidney disease with different patient characteristics and investigates the impact this has on their quality of life and physical functioning. The study also aims to explore the patient ‘living’ experience of these factors.
What does it involve and what do we hope to find out?
We hope to understand why people with kidney conditions suffer from a variety of health problems and symptoms, and what impact this has on their quality of life.
The study consists of different parts:
Part A will involve patients completing a questionnaire pack assessing symptoms, physical function, physical activity, dietary intake, and quality of life.
Part B will involve an optional additional visit to the renal research area in the hospital for further measures such as fat and muscle mass, muscle quality, physical function and strength, potential markers in the blood, and physical activity levels.
Part C is a qualitative part exploring the patient ‘living experience’ of kidney disease and the impact and role of lifestyle on patient quality of life, physical functioning, and health status.
Update August 2020: We have just added a new part to the DIME-KD study to explore the impact of the Covid pandemic on lifestyle and access to healthcare of people living with kidney disease.
Part CV involves an online survey for kidney patients, their significant others and the healthcare staff involved in their care. There is also an optional qualitative telephone interview to explore the issues in more depth.
Update September 2022: Another part has been added to the DIME-KD study:
Part E involves an online survey for patients with kidney disease and their significant others to explore their lived experience and impact of sleep problems and access to green and blue space.
Progress
DIMENSION-KD is still ongoing and multiple publications have been published so far including:
Lightfoot, CJ, Wilkinson, TJ, Patel, NA, Jones, CR, Smith, AC, et al. Patient activation and psychological coping strategies to manage challenging circumstances during the COVID-19 pandemic in people with kidney disease. Journal of Nephrology. 2024;1-12. https://doi.org/10.1007/s40620-023-01851-1
Memory, K.E., Wilkinson, T.J., Smith, A.C. and Lightfoot, C.J., 2022. A qualitative exploration of the facilitators and barriers to self-management in kidney transplant recipients. Journal of Nephrology, 35(7), pp.1863-1872. https://doi.org/10.1007/s40620-022-01325-w
Wilkinson, T.J., Lightfoot, C.J., Palmer, J. and Smith, A.C., 2022. Navigating the COVID-19 infodemic in those living with kidney disease: Access and trust in health information sources and the association with anxiety and depression. Current Medical Research and Opinion, 38(1), pp.35-42. https://doi.org/10.1080/03007995.2021.1984221
Lightfoot, C.J., Wilkinson, T.J., Memory, K.E., Palmer, J. and Smith, A.C., 2021. Reliability and validity of the patient activation measure in kidney disease: results of rasch analysis. Clinical Journal of the American Society of Nephrology, 16(6), pp.880-888. https://doi.org/10.2215/CJN.19611220
Wilkinson TJ, Memory KA, Lightfoot CJ, Palmer J, Smith AC. Determinants of patient activation and its association with cardiovascular disease risk in chronic kidney disease: a cross-sectional study. Health Expectations 2021, http://doi.org/10.1111/hex.13225
Lightfoot CJ, Wilkinson TJ, Palmer J, Kanavaki A, Smith AC. Patient and staff experiences of remote kidney healthcare: lessons learnt from COVID-19. Journal of Nephrology 2021. http://doi.org/10.1007/s40620-021-01175-y
Kanavaki AM, Lightfoot CJ, Palmer J, Wilkinson TJ, Smith AC, Jones CR. Kidney Care during COVID-19 in the UK: Perspectives of Healthcare Professionals on Impacts on Care Quality and Staff Well-Being. International Journal of Environmental Research and Public Health 2021. http://doi.org/10.3390/ijerph19010188
Wilkinson TJ, Palmer J, Gore EF, Smith AC. The validity of the ‘General Practice Physical Activity Questionnaire’ against accelerometery in patients with chronic kidney disease. Physiother Theory Pract. 2020 Dec 2:1-10. doi: http://doi.org/10.1080/09593985.2020.1855684
Wilkinson TJ, Gore EF, Vadaszy N, Nixon DGD, Watson EL, Smith AC. The utility of ultrasound as a valid and accurate diagnostic tool for sarcopenia: sex-specific cut-off values in chronic kidney disease. J Ultrasound Med 2021; 40:457–467. DOI: http://doi.org/10.1002/jum.15421
Wilkinson TJ, Ashman J, Baker LA, Watson EW, Smith AC. Quantitative muscle ultrasonography using 2D textural analysis: a novel approach to assess skeletal muscle structure and quality in chronic kidney disease. Ultrasonic Imaging 2021, https://doi.org/10.1177/01617346211009788
Results
A brief plain English summary of the SMILE-K study results can be found here
Evidence
Details of the study can be found here.
