MO880: Clinical Characteristics Associated With Human Activity Profile Scores in Hemodialysis Patients With Thyroid Dysfunction: A Substudy of the NIH THYROID-HD Trial

Abstract: BACKGROUND AND AIMS: Low physical activity is common in hemodialysis (HD) patients and is associated with adverse outcomes in this population (poor health-related quality of life, cardiovascular [CV] disease, death). Prior studies show that hypothyroidism is highly prevalent in HD patients, and is associated with worse self-reported physical function. METHOD: In a substudy of the ongoing multi-center NIH THYROID-HD Trial, we examined baseline physical activity scores determined by the Human Activity Profile (HAP), a validated 94-item instrument assessing daily activities across a wide range of energy expenditures, in HD patients with TSH levels in the high-normal (TSH >3–5 mIU/L) and subclinical hypothyroid range (TSH >5–10 mIU/L). The HAP was used to derive the Maximum Activity Score (MAS) and Adjusted Activity Score (AAS), representing greatest and mean estimated energy expenditures, respectively (range 0–94, segmented to low [74] scores). RESULTS: Among 100 HD patients who underwent baseline HAP assessment, the mean ± SD MAS and AAS scores were 48 ± 22 and 23 ± 27,  respectively; median (IQR) MAS and AAS scores were 49 (31–64) and 9 (0–39), respectively (Figure 1). In the overall cohort, 83% had low, 10% moderate and 7% high AAS scores. MAS and AAS scores were significantly lower in patients who had underlying diabetes versus those without diabetes (Table 1). There was also a trend towards lower (worse) MAS and AAS scores among older versus younger patients (≥65 versus >65 years, respectively) and patients with underlying coronary artery disease (CAD) versus those without CAD. In logistic regression analyses, older age (+∆ 1-year increments) was associated with higher likelihood of low MAS scores, and diabetes trended towards a significant association (defined as