An International Delphi Survey on Exercise Priorities in Chronic Kidney Disease

Abstract Introduction Defining the role of exercise in chronic kidney disease (CKD) is a top research priority for people with CKD. We aimed to achieve consensus on specific research priorities in exercise and CKD among an international panel of stakeholders. Methods Using the Delphi method, patients/caregivers, researchers, clinicians, and policy makers submitted their top research priorities in Round 1 and ranked their importance in Rounds 2 \u0026 3 using a 9-point Likert scale. Mean, median, and proportion of scores ranked 7-9 were calculated. Consensus was defined as priorities that scored above the overall mean and median score within each stakeholder panel. Qualitative description was used to understand participants’ rankings. Results Seventy participants (78% response) completed Round 1; 15 (21.4%) clinicians, 33 (47.1%) researchers, 13 (18.6%) policy makers, and 9 (12.9%) patients; (85.7%) completed Round 3. The top research priorities were: defining exercise-related outcomes meaningful to patients, identifying patients’ motivation and perspective towards exercise, understanding the effect of exercise on the risk of institutionalization, mortality, and mobility, and understanding the effect of pre-and post-transplant exercise on post-operative recovery. Themes from the qualitative analysis were: individualization, personal experience, and holistic approach to exercise (patients); the need to address common clinical problems (clinicians), developing targeted interventions (researchers) and the importance of evidence base development versus implementation (policy makers). Conclusions Preventing physical disability was a common priority. Policy makers emphasized that more efficacy studies were needed. Other panels expressed the need for holistic and targeted exercise interventions and for outcomes that address common clinical problems.