. Bonde

All Publications

• Twice Weekly Versus Thrice Weekly Hemodialysis - A Pilot Cross-Over Equivalence Trial. Clinical journal of the American Society of Nephrology : CJASN Lee, S., Pham, N. M., Montez-Rath, M. E., Bolanos, C. G., Bonde, S. S., Meyer, T. W., Sirich, T. L. 2024

  Abstract

  The 2015 Update of the Kidney Disease Outcomes Quality Initiative (KDOQI) Guideline for Hemodialysis Adequacy increased the contribution of residual kidney function in calculating standard Kt/V urea (stdKt/V urea ). However, no study has assessed the effect of prescribing twice weekly hemodialysis according to this guideline on patients' quality of life or uremic solute levels.Twenty six hemodialysis patients with average residual urea clearance (Kru) 4.7±1.8 ml/min and hemodialysis vintage of 12±15 months (range two months to 4.9 years) underwent a cross-over trial comparing four weeks of twice weekly hemodialysis and four weeks of thrice weekly hemodialysis. Twice weekly hemodialysis was prescribed to achieve stdKt/V urea 2.2 incorporating Kru using the 2015 KDOQI Guideline. Thrice weekly hemodialysis was prescribed to achieve spKt/V urea 1.3 regardless of Kru. Quality of life and plasma levels of secreted uremic solutes and β 2 microglobulin (β 2 m) were assessed at the end of each period.Equivalence testing between twice and thrice weekly hemodialysis based on the Kidney Disease Quality of Life instrument (primary analysis) was inconclusive. Symptoms as assessed by the secondary outcomes Dialysis Symptom Index and post-dialysis recovery time were not worse with twice weekly hemodialysis. StdKt/V urea was adequate during twice weekly HD (2.7±0.5), and ultrafiltration rate and plasma potassium were controlled with minimally longer treatment times (twice weekly: 195±20 vs. thrice weekly: 191±17 minutes). Plasma levels of the secreted solutes and β 2 m were not higher with twice weekly than thrice weekly hemodialysis.Twice weekly hemodialysis can be prescribed using the higher contribution assigned to Kru by the 2015 KDOQI Guideline. With twice weekly hemodialysis, quality of life was unchanged, and the continuous function of the residual kidneys controlled fluid gain and plasma levels of potassium and uremic solutes without substantially longer treatment times.

  View details for DOI 10.2215/CJN.0000000000000507

  View details for PubMedID 38922689

• Twice Weekly vs. Thrice Weekly Hemodialysis in Patients with Residual Kidney Function Lee, S., Pham, N. M., Bolanos, C. G., Bonde, S. S., Meyer, T. W., Sirich, T. L. AMER SOC NEPHROLOGY. 2023: B9

  View details for Web of Science ID 001635817300072

• STRONG-D: Strength training regimen for normal weight diabetics: Rationale and design CONTEMPORARY CLINICAL TRIALS Faroqi, L., Bonde, S., Goni, D., Wong, C., Wong, M., Walai, K., Araya, S., Azamey, S., Schreiner, G., Bandy, M., Raghuram, S., Mittal, A., Mukherji, A., Wangdak, T., Talamoa, R., Vera, K., Nacif-Coelho, C., Groppo, L., Christensen, M., Johannsen, N., Haddad, F., Moharir, M., Palaniappan, L. 2019; 78: 101–6

  View details for DOI 10.1016/j.cct.2019.01.005

  View details for Web of Science ID 000461403500011

• STRONG-D: Strength training regimen for normal weight diabetics: Rationale and design. Contemporary clinical trials Faroqi, L., Bonde, S., Goni, D. T., Wong, C. W., Wong, M., Walai, K., Araya, S., Azamey, S., Schreiner, G., Bandy, M., Raghuram, S. S., Mittal, A., Mukherji, A., Wangdak, T., Talamoa, R., Vera, K., Nacif-Coelho, C., Cde, L. G., Christensen, M., Johannsen, N., Haddad, F., Moharir, M., Palaniappan, L. 2019

  Abstract

  BACKGROUND: Currently, there is a lack of data on effective lifestyle recommendations for normal-weight diabetics (NWD), who can represent up to 1 in 5 individuals with Type II Diabetes Mellitus (T2DM). NWD is especially prevalent in Asian populations and the elderly. Specific exercise treatment recommendations are needed for patients with normal-weight diabetes (NWD), as those in this category face higher mortality rates than overweight and obese diabetics. Standard T2DM treatment recommends aerobic training; however, performing aerobic training alone may not be appropriate for NWD and strength training may be a more effective treatment recommendation.OBJECTIVE: While it is known that strength and aerobic training are beneficial in obese diabetics, there is currently insufficient evidence to recommend this regimen in NWD. The Strength Training Regimen for Normal Weight Diabetics (STRONG-D) study aims to determine the best exercise regimen for NWD and address the current lack of appropriate physical activity recommendations for this population. The primary goal of this study is to determine whether strength training aids glycemic control better than aerobic training in NWD.STUDY DESIGN: STRONG-D is a three-arm randomized controlled trial designed to compare the clinical effectiveness of structured strength training only, aerobic training only, and combination (strength + aerobic) training sessions, modeled after the intervention in the Health Benefits of Aerobic and Resistance Training in T2DM patients (HART-D) study. Potential participants meeting eligibility criteria of HbA1c values of 6.5% to 13.0% and BMI of 18.5 kg/m2 to 25 kg/m2 will be enrolled. After randomization, participants will begin a 9-month exercise intervention. The primary outcomes will be HbA1c levels. The secondary endpoints will include physical fitness, body composition measured by Dual X-Ray Absorptiometry (DXA) scans, and leg strength and endurance measured by Biodex testing. Initial follow-up visits will occur at 3 months, 6 months, and 9 months. To determine the long-term effects of the exercise intervention, passive follow-up will continue via electronic health records (EHR) until a 24-month follow-up visit. A total of 282 participants will be randomized into the three study arms determine the clinically significant differences between strength-only, aerobic-only and combination regimens.

  View details for PubMedID 30625372

• Evaluating the clinical implementation of structured exercise: A randomized controlled trial among non-insulin dependent type II diabetics CONTEMPORARY CLINICAL TRIALS Faroqi, L., Wong, M., Bonde, S., Wong, C., Walai, K., West, W., Goni, D., Araya, S., Azamey, S., Nacif-Coelho, C., Raghuram, S., Vera, K., Mittal, A., Groppo, L., Christensen, M., Johannsen, N., Haddad, F., Moharir, M., Palaniappan, L. 2018; 74: 25–31

  View details for DOI 10.1016/j.cct.2018.09.003

  View details for Web of Science ID 000449893200004

• Evaluating the clinical implementation of structured exercise: A randomized controlled trial among non-insulin dependent type II diabetics. Contemporary clinical trials Dpm, L. F., Wong, M., Bonde, S., Wong, C. W., Walai, K., West, W., Goni, D. T., Araya, S., Azamey, S., Nacif-Coelho, C., Raghuram, S. S., Vera, K., Mittal, A., Cde, L. G., Christensen, M., Johannsen, N., Haddad, F., Moharir, M., Palaniappan, L. 2018

  Abstract

  BACKGROUND: The American Diabetes Association (ADA) currently recommends 150 min of moderate-intensity aerobic exercise per week and resistance exercise at least twice per week in individuals with type 2 diabetes (T2DM) to improve overall health.1 However, approximately 38% of patients with T2DM do not exercise at recommended levels and 31% do not exercise at all.2 The efficacy of structured exercise interventions has been proven effective in reducing glycosylated hemoglobin A1c (HbA1c) levels in patients, but practical approaches are needed to translate these findings into the clinical setting.3-7 OBJECTIVE: The Initiate and Maintain Physical Activity in Clinics (IMPACT) Study aims to compare structured group exercise within the clinic to usual care in T2DM patients. The main purpose of the study is to determine the optimal and feasible level and weekly frequency of structured contact in a clinical setting needed to initiate and maintain physical activity recommendations long-term.STUDY DESIGN: IMPACT is a longitudinal, randomized-controlled study designed to track study participants over 30 months. Once study participants have met eligibility and enrollment criteria, they are randomized and enrolled into one of three arms: 1* per week exercise, 3* per week exercise, or the usual care control group. After randomization, participants begin Phase 1: Initiate lasting 6 months. Over the course of Phase 1, participants in the exercise groups will attend instructor led group training at a Stanford approved physical fitness facility. At the end of 6 months, participants enter Phase 2: Maintain lasting 24 months. Over the course of Phase 2, participants in all three arms will attend periodic follow-up visits for clinical measurements and survey administration for their final two years of participation. These findings will enable the clinical implementation of a structured exercise regimen designed to specifically address the aerobic and resistance training recommendations for patients with T2DM.

  View details for PubMedID 30205182