Dr Yiming Zhao Lit
Clinical Associate Professor, Medicine - Nephrology
Administrative Appointments
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Nephrology Section Chief, Palo Alto VA Healthcare System (2022 - Present)
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Program Director, Stanford Nephrology Fellowship Training Program (2017 - Present)
Professional Education
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Fellowship, Massachusetts General Hospital and Brigham and Women's Hospital, Nephrology (2002)
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Residency, Massachusetts General Hospital, Internal Medicine (2000)
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M.D., Harvard Medical School (1997)
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B.S., Yale University, Molecular Biophysics and Biochemistry (1993)
All Publications
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Effect of a Home-Based Exercise Program on Indices of Physical Function and Quality of Life in Elderly Maintenance Hemodialysis Patients.
Kidney & blood pressure research
2021: 1–11
Abstract
BACKGROUND: Patients on maintenance hemodialysis (MHD) exhibit muscle wasting and impaired physical function which can be reversed with regular exercise, but accessibility to exercise programs for this unique population is lacking. We assessed the efficacy of a home-based exercise program on a broad range of indices of physical function, quality of life (QoL), and cognitive decline in patients with MHD.DESIGN AND METHODS: Twenty-eight MHD patients, mean age 66 ± 7 years, were randomized to a 12-week home-based, case-managed aerobic and resistance exercise program or to usual care (13 exercise and 15 usual care). Comparisons were made for peak VO2, ventilatory inefficiency, 6-min walk test (6MWT), 1-min sit-to-stand (1STS), muscle strength, body composition, QoL, and cognitive measures.RESULTS: Peak VO2 improved significantly in the exercise group (p = 0.01 between groups); exercise time improved by 41 and 36% at the ventilatory threshold and peak exercise, respectively (p < 0.01 between groups), but there were no differences in ventilatory efficiency. Trends for improvements in 6MWT and 1STS in the exercise group were observed, but no differences were observed in strength or body composition. Among measures of QoL, general health determined by the SF-36 improved in the exercise group, but there were no differences between groups in cognitive function.CONCLUSIONS: MHD patients improved exercise capacity and some indices of QoL following a 12-week home-based exercise program. Home-based exercise is feasible for patients undergoing MHD and may help to obviate accessibility barriers to regular exercise.
View details for DOI 10.1159/000514269
View details for PubMedID 33774634
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Association of physical function and performance with peak VO2 in elderly patients with end stage kidney disease.
Aging clinical and experimental research
2021
Abstract
BACKGROUND: Physical function is impaired in end stage renal disease (ESRD). Various instruments have been used to assess the functional capabilities and health status of patients with ESRD, but it is not known which has the best association with peak VO2.AIMS: To assess the association between functional measures in ESRD.METHODS: Thirty nine elderly ESRD patients were evaluated with commonly used functional, health status, and quality of life measures, including maximal cardiopulmonary exercise testing (CPET), 6-min walk (6MWT), sit-to-stand test (STS), Veterans Specific Activity Questionnaire (VSAQ), upper and lower body strength, pulmonary function tests, and body composition determined by dual X-ray absorptiometry. The association between performance on these functional tools, clinical variables, and exercise test responses was assessed, and a non-exercise test multivariate model was developed to predict peak VO2.RESULTS: Peak VO2 was modestly related to VSAQ score (r=0.59, p<0.01), indices of upper and lower body strength (r=0.45, p<0.01 for both), and FEV1 (r=0.51, p<0.01). Functional and quality of life questionnaires were generally poorly related to one another and to peak VO2. In a multivariate model, 6MWT performance, forced expiratory volume in 1s (FEV1), and VSAQ score were the best predictors of peak VO2, yielding a multiple R=0.82, accounting for 67% of the variance in peak VO2.CONCLUSION: Exercise capacity can be reasonably estimated using non-exercise test variables in patients with ESRD, including a symptom questionnaire (VSAQ), 6MWT and FEV1.CLINICAL TRIAL INFORMATION: ClinicalTrials.gov identifier: NCT01990495. Registered Nov 21, 2013.
View details for DOI 10.1007/s40520-021-01801-6
View details for PubMedID 33686542
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Skeletal Muscle Fiber Type In Older Patients Receiving Maintenance Hemodialysis Treatment
LIPPINCOTT WILLIAMS & WILKINS. 2020: 396
View details for Web of Science ID 000590026301428