INTRODUCTION: Patients are often instructed to engage in multiple weekly sessions of exercise to increase physical activity. We aimed to determine whether assignment to a supervised exercise regimen increases overall weekly activity in individuals with chronic kidney disease (CKD). METHOD(S): We performed a secondary analysis of a pilot randomized 2x2 factorial design trial examining the effects of diet and exercise (10% to 15% reduction in caloric intake, 3 supervised exercise sessions/wk, combined diet restriction/exercise, and control). Activity was measured as counts detected by accelerometer. Counts data were collected on all days for which an accelerometer was worn at baseline, month 2, and month 4 follow-up. The primary outcome was a relative change from baseline in log-transformed counts/min. Generalized estimating equations were used to compare the primary outcome in individuals in the exercise group and the nonexercise group. RESULT(S): We examined 111 individuals randomized to aerobic exercise or usual activity (n = 48 in the exercise group and n = 44 controls). The mean age was 57 years, 42% were female, and 28% were black. Median overall adherence over all time was 73%. Median (25th to 75th percentile) counts/min over nonsupervised exercise days at months 2 and 4 were 237.5 (6.5 to 444.4) for controls and 250.9 (7.7 to 529.8) for the exercise group (p = 0.74). No difference was observed in the change in counts/min between the exercise and control groups over 3 time points (beta (fold change) 0.96, 95% confidence interval (CI) 0.91 to 1.02). CONCLUSION(S): Engaging in a supervised exercise program does not increase overall weekly physical activity in individuals with stage 3 to 4 CKD.

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