title: Six-minute walk test in children and adolescents with renal diseases: tolerance, reproducibility and comparison with healthy subjects.
abstract: OBJECTIVE
  To evaluate exercise tolerance and the reproducibility of the six-minute walk test in Brazilian children and adolescents with chronic kidney disease and to compare their functional exercise capacities with reference values for healthy children.
  
  
  METHODS
  This cross-sectional study assessed the use of the six-minute walk test in children and adolescents aged 6-16 with stage V chronic kidney disease. For statistical analysis of exercise tolerance, including examinations of correlations and comparisons with reference values, the longest walked distances were considered. The reproducibility of the six-minute walk test was assessed using intraclass correlation coefficients.
  
  
  RESULTS
  A total of 38 patients (14 females and 24 males) were evaluated, including 5 on peritoneal dialysis, 12 on hemodialysis and 21 who had undergone renal transplantation, with a median age of 11.2 years (6.5-16). The median walked distance was 538.5 meters (413-685) and the six-minute walk test was found to be reproducible. The walked distance was significantly correlated with age (r=0.66), weight (r=0.76), height (r=0.82), the height Z score (r=0.41), hemoglobin (r=0.46), hematocrit (r=0.47) and post-test systolic blood pressure (r=0.39). The chronic kidney disease patients predicted walked distance was 84.1% of the reference value according to age, 90.6% according to age-corrected height and 87.4% according to a predictive equation.
  
  
  CONCLUSIONS
  The stage V chronic kidney disease patients had a significantly decreased functional exercise capacity, as measured by the six-minute walk test, compared with the healthy pediatric reference values. In addition, the six-minute walk test was shown to be well tolerated, reliable and applicable as a low-cost tool to monitor functional exercise capacity in patients with renal disease.
authors.affiliation: Instituto da Criança do Hospital das Clínicas da Faculdade de Medicina da Universidade de São Paulo,, São Paulo, Brazil.
authors.forename: Flávia Tieme
authors.initials: FT
authors.lastname: Watanabe
authors.affiliation: Divisão de Fisioterapia, Unidade de Nefrologia Pediátrica, São Paulo/, SP, Brazil.
authors.forename: Vera Herminia Kalika
authors.initials: VH
authors.lastname: Koch
authors.affiliation: Instituto da Criança do Hospital das Clínicas da Faculdade de Medicina da Universidade de São Paulo,, São Paulo, Brazil.
authors.forename: Regina Celia Turola Passos
authors.initials: RC
authors.lastname: Juliani
authors.affiliation: Instituto da Criança do Hospital das Clínicas da Faculdade de Medicina da Universidade de São Paulo,, São Paulo, Brazil.
authors.forename: Maristela Trevisan
authors.initials: MT
authors.lastname: Cunha
mesh_terms: D000293:Adolescent; D001938:Brazil; D002648:Child; D003430:Cross-Sectional Studies; D004417:Dyspnea / Q000503:physiopathology; D005080:Exercise Test; D017079:Exercise Tolerance / Q000502:physiology*; D005260:Female; D064368:Healthy Volunteers / Q000706:statistics & numerical data; D006801:Humans; D008297:Male; D011237:Predictive Value of Tests; D012016:Reference Values; D051436:Renal Insufficiency, Chronic / Q000503:physiopathology*; D015203:Reproducibility of Results; D013997:Time Factors; D016138:Walking / Q000502:physiology*