Browsing by Person "Mercer, Tom"

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A randomized trial of intravenous iron supplementation and exercise on exercise capacity in iron-deficient non-anemic patients with chronic kidney disease
(Elsevier, 2023-05-09) Greenwood, Sharlene A.; Oliveira, Benjamin A.; Asgari, Elham; Ayis, Salma; Baker, Luke A.; Beckley-Hoelscher, Nicholas; Goubar, Aicha; Banerjee, Debasish; Bhandari, Sunil; Chilcot, Joseph; Burton, James O.; Kalra, Philip A.; Lightfoot, Courtney J.; Macdougall, Iain C.; McCafferty, Kieran; Mercer, Tom; Okonko, Darlington O.; Reid, Chante; Reid, Fiona; Smith, Alice C.; Swift, Pauline A.; Mangelis, Anastasios; Watson, Emma; Wheeler, David C.; Wilkinson, Thomas J.; Bramham, Kate
Introduction Patients with chronic kidney disease (CKD) are often iron deficient, even when not anemic. This trial evaluated whether iron supplementation enhances exercise capacity. Methods Prospective, multicenter double-blind randomized controlled trial of non-dialysis patients with CKD and iron deficiency but without anemia (Hemoglobin (Hb)>110 g/l). Patients assigned (1:1): intravenous (IV) iron therapy, or placebo. An 8-week exercise programme commenced at week 4. Primary outcome was mean between-group difference in six-minute walk test (6MWT) at 4 weeks. Secondary outcomes included: 6MWT at 12 weeks, Transferrin Saturation (TSAT), serum ferritin (SF), hemoglobin (Hb), renal function, muscle strength, functional capacity, quality of life and adverse events at baseline, 4, 12 weeks. Mean between-group differences were analysed using ANCOVA models. Results Among 75 randomized patients, mean (SD) age for iron therapy (n=37) vs placebo (n=38) was 54(16) vs. 61(12) yrs; eGFR [34(12) vs. 35(11)ml/min/1.73m2], TSAT [23(12) vs. 21(6)]%; SF [57(64) vs. 62(33)]μg/L; Hb [122.4 (9.2) vs. 127 (13.2)g/L]; 6MWT [384 (195) vs. 469 (142)metres] at baseline, respectively. No significant mean between-group difference was observed in 6MWT distance at 4 weeks. There were significant increases in SF and TSAT at 4 and 12 weeks (p<0.02), and Hb at 12 weeks (p=0.009). There were no between-group differences in other secondary outcomes and no adverse events attributable to iron therapy. Conclusion This trial didn’t demonstrate beneficial effects of IV iron therapy on exercise capacity at 4 weeks. A larger study is needed to confirm if IV iron is beneficial in non-dialysis patients with CKD who are iron-deficient. Trial Registration EudraCT: 2018-000144-25 Registered 28/01/2019.
Adherence to a Diet and Exercise Weight Loss Intervention amongst Women at Increased Risk of Breast Cancer
(Bentham Open, 2010) Harvie, M.; Cohen, H.; Mason, C.; Mercer, Tom; Malik, R.; Adams, J.; Evans, D. G. R.; Hopwood, P.; Cuzick, J.; Howell, A.
Maintained weight loss of five percent or more may reduce risk of breast cancer. We conducted a feasibility pilot study to assess adherence to an intensive 12 month diet and exercise weight control intervention aimed to achieve and maintain a five percent or greater weight loss as compared to a usual care group receiving written advice only. Overweight premenopausal women at increased risk of breast cancer were enrolled in a 12 month diet and exercise weight loss programme (n = 40) or a comparison group receiving usual care (n = 39). Changes in weight, general (DXA, bioelectrical impedance) and central adiposity (intra abdominal fat; MRI, waist), dietary intake, physical activity, cancer worry (Lerman score) and quality of life (SF-36) were assessed at 6 and 12 months, as well as long-term changes in weight and adiposity 12 and 42 months after the end of the intervention. Target weight loss (5%) was achieved by 55% of the intervention group at the end of the 12 month intervention but maintained by fewer at 24 (39%) and 54 months -(21%). Overall the intervention group achieved significant reductions in weight (mean [95% CI] -4.6 [-6.4 to -2.8] %), body fat (-4.0 [-5.2 to -2.7] ) kg, intra abdominal fat (-25.0 [-39.0 to -8.0])% and waist circumference (-4.0 [-6.8 to -2.0] cm) during the 12 month intervention and reported large reductions in intake of energy (-24.3 [-33.2 to -15.1] %), fat (-32 [-44 to -20] %), and alcohol (-35 [-52 to -13] %), and increased moderate activity (27 [7 to 44] minutes/day). These parameters did not change in the usual care group (all P < 0.05). A small proportion of the usual care group lost and maintained > 5% of their weight at 6 (16%), 12 (11%), 24 (11%) and 54 (13%) months (P < 0.05 at all time points). The intervention increased physical well being (SF-36; P < 0.05) but had no measurable effect on mental well being or cancer worry. Weight loss is achievable within our high risk women but not more so than in previous studies in the general population. Further studies are required to better understand factors which can promote compliance in women at increased risk of breast cancer.
Aerobic or Resistance Training and Pulse Wave Velocity in Kidney Transplant Recipients: A 12-Week Pilot Randomized Controlled Trial (the Exercise in Renal Transplant [ExeRT] Trial)
(2015-07-22) Greenwood, Sharlene A.; Koufaki, Pelagia; Mercer, Tom; Rush, Robert; O'Connor, Ellen; Tuffnell, Rachel; Lindup, Herolin; Haggis, Lynda; Dew, Tracy; Abdulnassir, Lyndsey; Nugent, Eilish; Goldsmith, David; Macdougall, Iain C.
Background: Cardiovascular disease remains the leading cause of death in kidney transplant recipients. This pilot study examined the potential effect of aerobic training or resistance training on vascular health and indexes of cardiovascular risk in kidney transplant recipients. Study Design: Single-blind, randomized, controlled, parallel trial. Setting & Participants: 60 participants (mean age, 54 years; 34 men) were randomly assigned to aerobic training (n = 20), resistance training (n = 20), or usual care (n = 20). Participants were included if they had a kidney transplant within 12 months prior to baseline assessment. Patients were excluded if they had unstable medical conditions or had recently started regular exercise. Intervention: Aerobic training and resistance training were delivered 3 days per week for a 12-week period. The usual-care group received standard care. Outcomes & Measurements: Pulse wave velocity, peak oxygen uptake (Vo 2peak), sit-to-stand 60, isometric quadriceps force, and inflammatory biomarkers were assessed at 0 and 12 weeks. Results: The anticipated 60 participants were recruited within 12 months. 46 participants completed the study (aerobic training, n=13; resistance training, n=13; and usual care, n=20), resulting in a 23% attrition rate. Analyses of covariance, adjusted for baseline values, age, and dialysis vintage pretransplantation, revealed significant mean differences between aerobic training and usual care in pulse wave velocity of-2.20.4 (95% CI,-3.1 to-1.3) m/s (P <0.001) and between resistance training and usual care of-2.60.4 (95% CI,-3.4 to-1.7) m/s (P <0.001) at 12 weeks. Secondary analyses indicated significant improvements in Vo 2peak in the aerobic training group and in Vo 2peak, sit-to-stand 60, and isometric muscle force in the resistance training group compared with usual care at 12 weeks. There were no reported adverse events, cardiovascular events, or hospitalizations as a result of the intervention. Limitations: Pilot study, small sample size, no measure of endothelial function. Conclusions: Both aerobic training and resistance training interventions appear to be feasible and clinically beneficial in this patient population. 2015 National Kidney Foundation, Inc.
An alternative histochemical method to simultaneously demonstrate muscle nuclei and muscle fibre type
(Springer Verlag, 2003-06) Sakkas, G. K.; Ball, Derek; Mercer, Tom; Naish, P. F.
We present a modified histochemical method to examine, simultaneously, nuclei and fibre type in human skeletal muscle. The new procedure (Haem-ATPase) is based on two previously used histochemical protocols. Biopsies were obtained from the rectus abdominis muscle of patients undergoing elective abdominal surgery. Fibre type composition, cross-sectional area (CSA) and nuclei to fibre ratio (N:F) were determined from frozen sections of each biopsy. To test the validity of the new method, serial sections of each biopsy were stained separately using the standard and modified methods. No differences were found in fibre type distribution, mean-weighted CSA and N:F when comparing the modified method with the standard methods. The Haem-ATPase method was found to shrink fibre size by at least 3% (P>0.05) compared with the established myosin acid labile method. We propose that this modified technique is suitable for initial examination of both the nuclei and fibre type in the same frozen sections of human skeletal muscle.
An examination of the reproducibility and utility of isokinetic leg strength assessment in women.
(University of Victoria Press, 1994) Gleeson, Nigel; Mercer, Tom; Bell, F. I.; Van Gyn, G. H.
An examination of the validity and utility of selected methods for the assessment of habitual physical activity.
(E & FN Spon, 1995) Mitchell, J.; Mercer, Tom; Springate, T.; Atkinson, G.; Reilly, T.
An investigation into the minimum accelerometry wear time for reliable estimates of habitual physical activity and definition of a standard measurement day in pre-school children.
(IOP Science, 2014-11) Hislop, Jane; Law, James; Rush, Robert; Grainger, Andrew; Bulley, Catherine; Reilly, John J.; Mercer, Tom
The purpose of this study was to determine the number of hours and days of accelerometry data necessary to provide a reliable estimate of habitual physical activity in pre-school children. The impact of a weekend day on reliability estimates was also determined and standard measurement days were defined for weekend and weekdays. Accelerometry data were collected from 112 children (60 males, 52 females, mean (SD) 3.7 (0.7)yr) over 7 d. The Spearman-Brown Prophecy formula (S-B prophecy formula) was used to predict the number of days and hours of data required to achieve an intraclass correlation coefficient (ICC) of 0.7. The impact of including a weekend day was evaluated by comparing the reliability coefficient (r) for any 4 d of data with data for 4 d including one weekend day. Our observations indicate that 3 d of accelerometry monitoring, regardless of whether it includes a weekend day, for at least 7 h d-1 offers sufficient reliability to characterise total physical activity and sedentary behaviour of pre-school children. These findings offer an approach that addresses the underlying tension in epidemiologic surveillance studies between the need to maintain acceptable measurement rigour and retention of a representatively meaningful sample size.
Ankle Kinematics and Temporal Gait Characteristics over the Duration of a 6-Minute Walk Test in People with Multiple Sclerosis Who Experience Foot Drop
(Hindawi Publishing Corporation, 2018-07-02) van der Linden, Marietta; Andreopoulou, Georgia; Scopes, Judy; Hooper, Julie; Mercer, Tom
Foot drop is a common gait impairment in people with MS (pwMS) but in some foot drop may only occur after a period of prolonged walking and may be a sign of motor fatigability. The purpose of the study was to explore whether, for pwMS, an adapted six-minute walk test (6minWT) would result in an increase in foot drop as measured using electrogoniometry. Sagittal ankle kinematics were recorded for fifteen participants (10 females and 5 males, aged 37-64) with MS (EDSS 4-6) throughout the 6minWT. Ankle kinematics and temporal stride parameters were compared between the first and last 10 gait cycles of the 6minWT. Peak dorsiflexion in swing was significantly reduced at the end of the 6minWT compared to the start, with six of the fifteen participants having a decrease of two degrees or more. Statistically significant changes in temporal stride parameters suggested a decrease in walking speed. Our results suggest that with the protocol used in this study it is feasible to identify patients who experience increased foot drop as a result of a prolonged exercise task.
Are tactile function and body awareness of the foot related to motor outcomes in children with upper motor neuron lesions?
(Frontiers Media, 2024-03-01) Marsico, Petra; Lea Meier; van der Linden, Marietta; Mercer, Tom; Van Hedel, Hubertus J.
Introduction: Somatosensory function can be reduced in children with Upper Motor Neuron (UMN) lesions. Therefore, we investigated relationships between somatosensory functions of the foot and motor outcomes in children with UMN lesions.In this cross-sectional study, we assessed the Tactile Threshold (TT) with monofilaments and body awareness with Tactile Localisation Tasks for spatial-related action (TLTaction) and structural-related perception (TLTperception) body representation at the foot sole. Furthermore, we assessed four motor outcomes: the Selective Control Assessment of the Lower Extremity (SCALE), the modified Timed Up and Go test (mTUG), the Gillette Functional Assessment Questionnaire (FAQ), and the Functional Mobility Scale (FMS). Spearman's correlations (ρ) were applied to assess relationships between the somatosensory function of the foot sole and the applied motor outcomes.Results: Thirty-five children with UMN lesions, on average 11.7 ± 3.4 years old, participated. TLTperception correlated significantly with all lower limb motor outcomes p<0.05),. TLTperception correlated strongly with the Gross Motor Function Classification System (|ρ|=0.62; p=0.001) in children with cerebral palsy (n=24).Discussion: Assessing structural body representation of the foot sole should be considered when addressing lower limb motor impairments, including gait, in children with upper motor neuron lesions. Our results suggest that the assessment of tactile function and spatial body representation may be less related to lower limb motor function.
Assessing Proprioception in Children with Upper Motor Neuron Lesions: Feasibility, validity, and reliability of the Proprioception Measurement Tool (ProMeTo)
(Frontiers Media, 2024-08-09) Marsico, Petra; Meier, Lea; Buchmann, Anke; Kläy, Andrina; van der Linden, Marietta; Mercer, Tom; Van Hedel, Hubertus J.
Introduction: To investigate the feasibility, discriminative and convergent validity, and reliability of a lower limb sensor-based proprioception measure in children with upper motor neuron (UMN) lesions. Method: We assessed three proprioception modalities (joint movement, joint position, and dynamic position sense) of the lower limbs in 49 children with UMN lesions and 50 typically developing (TD) peers (5-19y). Forty-three children with UMN lesion had a congenital and six an acquired brain lesion and 82% are able to walk without a walking aid. We evaluated the feasibility, compared the test results between children with UMN lesions and TD peers, and calculated Spearman correlations (rs) between the modalities. We quantified relative reliability with Intra-Class Correlation Coefficients (ICC) and absolute reliability with Smallest Detectable Changes (SDC). Results: Most children with UMN lesions (>88%) found the tests easy to perform. The children with UMN lesions had significantly (p<0.001) lower proprioceptive function than the TD children. The correlation between the three proprioceptive modalities was moderate to high (0.50 ≤ rs ≤ 0.79). The relative reliability for test-retest and the inter-rater reliability was moderate to high (ICCs=0.65-0.97), and SDC between 2° and 15°. Discussion: The three tests are feasible, and discriminative and convergent validity and reliability were confirmed. Further studies should investigate the influence on motor function and performance in children with UMN lesions.
Assessing the efficacy of exercise training in patients with chronic disease
(Lippincott Williams & Wilkins, 2002-08) Mercer, Tom; Koufaki, Pelagia; Nash, P. F.
KOUFAKI, P., P. F. NASH, and T. H. MERCER. Assessing the efficacy of exercise training in patients with chronic disease. Med. Sci. Sports Exerc., Vol. 34, No. 8, pp. 1234-1241, 2002. Purpose: The purpose of this study was to evaluate the meaningfulness of exercise training responses in patients with end stage renal disease (ESRD). Methods: Eighteen ESRD patients [(mean +/- SD); 54.3 +/- 17.1 yr] completed a training regime progressing to accumulate 40 min of stationary cycling, three times per week for 6 months. [latin capital V with dot above]O2peak determined via incremental cycle ergometer protocol, and [latin capital V with dot above]O2 kinetics determined from a transition from unloaded pedalling to an exercise intensity corresponding to 90% of VT, were assessed at baseline and at 3 and 6 months of training. Results: Repeated measures analysis of variance revealed significant changes (P < 0.05) on the time factor for [latin capital V with dot above]O2peak, [latin capital V with dot above]O2-VT, and [latin capital V with dot above]O2 kinetics. Post hoc analysis revealed that [latin capital V with dot above]O2peak and [latin capital V with dot above]O2 kinetics significantly (P < 0.05) improved at 3 months of training with no further improvements thereafter. Analysis of individual subject response data revealed that after 3 months of training, 61% of the patients improved [latin capital V with dot above]O2peak by greater than the standard error of measurement (SEM = 0.07 L[middle dot]min-1). At 6 months of training, ~89% of the patients improved by more than the SEM [latin capital V with dot above]O2 kinetics improved by more than the SEM (12.3 s) at 3 months of training in ~55% of the patients, with no increase in the number of patients exhibiting faster time constants after 6 months of training. Conclusion: Although conventional statistical analyses indicate that exercise training favorably alters [latin capital V with dot above]O2peak and oxygen uptake kinetics of patients with ESRD, it is apparent that considerable interindividual variability exists in the response to training. Consideration of the SEM data underscores the heterogeneity of adaptive response in this patient group and may be valuable in assessing the efficacy of therapeutic exercise rehabilitation.
Assessment and Monitoring of Physical Function for People With CKD
(2009-11) Koufaki, Pelagia; Mercer, Tom
Although low and deteriorating physical function are increasingly recognized as key characteristics of CKD, assessment of physical function does not yet form part of the routine clinical monitoring of this patient group. This is somewhat surprising as measures of physical function, from across the entire functional measurement spectrum, have been shown to be related to clinically important outcomes (morbidity, quality of life and increasingly survival) in patients being treated for CKD. In order to promote a standardized approach to assessment of people with CKD, it is recommended that renal professionals adopt the physical function and measurement classification systems of the International Classification Framework of Functioning, Disability and Health. Selection of physical function assessment tool(s) is influenced by the intended goal of the assessment (e.g., clinical assessment, tracking of progress with physical activity, research purposes, diagnostic purposes), the personal characteristics of the patient, and also by the prevailing information quality requirements and potential operational constraints (e.g., measurement burden, patient inclusiveness/sample size, cost). As exercise tolerance, functional capacity, and functional status assessments have been shown to be safe, feasible, and clinically useful, it is recommended that their implementation be incorporated within clinical management protocols for the patient with CKD. 2009 National Kidney Foundation, Inc.
Assessment of the stage of exercise behaviour change in young adult females.
(University of Victoria Press, 1994) Buxton, Kim; Mercer, Tom; Wyse, Jon; Bell, F. I.; Van Gyn, G. H.
Assessment of VO2 max of competitive cyclists using conventional ergometry versus a sports-specific test.
(Illinois Human Kinetics, 1988) Lavoie, N. F.; Mercer, Tom; Ciolfi, M. A.; Burke, E R; Newsom, M. M.
Association of postural balance and falls in adult patients receiving haemodialysis: A prospective cohort study
(Elsevier, 2020-08-30) Zanotto, Tobia; Mercer, Tom; van der Linden, Marietta; Traynor, Jamie P.; Doyle, Arthur; Chalmers, Karen; Allan, Nicola; Shilliday, Ilona; Koufaki, Pelagia; Funder: British Kidney Patient Association–British Renal Society; Grant(s): 16-003
Background Static postural balance performance is often impaired in people receiving haemodialysis (HD) for the treatment of stage-5 chronic kidney disease (CKD-5). However, the question as to whether lower postural balance is associated with adverse clinical outcomes such as falls has not been addressed yet. Research question We conducted a prospective cohort study to explore the association between static postural balance and falls in people receiving HD. We hypothesised that higher postural sway would be associated with increased odds of falling. Methods Seventy-five prevalent CKD-5 patients receiving HD (age: 61.8 ± 13.4 years) from three Renal Units were enrolled in this prospective cohort study. At baseline, postural balance was assessed with a force platform in eyes open (EO) and eyes closed (EC) conditions. Centre of pressure (CoP) measures of range, velocity and area were taken for the analysis. Falls experienced by study participants were prospectively recorded during 12 months of follow-up. Secondary outcomes included timed-up and go, five-repetition sit-to-stand test and the Tinetti falls efficacy scale (FES). Results In multivariable logistic regression analysis, higher CoP range in medial-lateral direction during EC was associated with increased odds of falling (OR: 1.04, 95 %CI: 1.00−1.07, p = 0.036). In ROC curve analysis, CoP velocity in EO exhibited the greatest prognostic accuracy (AUC: 0.69, 95 %CI: 0.55−0.82), however this was not statistically different from CoP measures of area and range. None of the postural balance measures exceeded the prognostic accuracy of the FES (AUC: 0.70, 95 %CI: 0.58−0.83, p = 0.005). Significance This prospective cohort study showed that higher postural sway in medial-lateral direction was associated with increased odds of falling in people receiving HD. CoP measures of range, velocity and area displayed similar prognostic value in discriminating fallers from non-fallers. The overall utility of static posturography to detect future fall-risk may be limited in a clinical setting.
Atrophy of non-locomotor muscle in patients with end-stage renal failure
(Oxford University Press, 2003) Sakkas, G. K.; Ball, Derek; Mercer, Tom; Sargeant, A. J.; Tolfrey, K.; Naish, P. F.
Background. All previous histological studies of skeletal muscles of patients with renal failure have used locomotor muscle biopsies. It is thus unclear to what degree the observed abnormalities are due to the uraemic state and how much is due to disuse. The present study was undertaken to attempt to investigate this question by examining a non-locomotor muscle (rectus abdominis) in patients with end-stage renal failure. Methods. Biopsies from rectus abdominis were obtained from 22 renal failure patients (RFPs) undergoing surgical Tenchkoff catheter implantation for peritoneal dialysis and 20 control subjects undergoing elective abdominal surgery. Histochemical staining of frozen sections and morphometric analysis was used to estimate the proportion of each fibre type, muscle fibre area and capillary density. Myosin heavy chain composition was examined by SDS-PAGE. Results. There were no differences in fibre type distribution between RFPs and controls. All RFPs showed fibre atrophy [mean cross-sectional area (CSA) 3300 1100 m2, compared to 4100 1100 m2 in controls (P < 0.05)]. All fibre types were smaller in mean CSA in RFPs than in controls (15, 26 and 28% for types I, IIa and IIx, respectively). These differences could not be accounted for by differences in age, gender or cardiovascular or diabetic comorbidity. Muscle fibre capillarization, expressed as capillaries per fibre or capillary contacts per fibre, was significantly less in RFPs. Conclusions. Since a non-locomotor muscle was examined, the effects of disuse as a cause of atrophy have been minimized. It is likely, therefore, that the decreased muscle fibre CSA and capillary density of RFPs compared to controls were due predominantly to uraemia itself.
Baroreflex function, haemodynamic responses to an orthostatic challenge, and falls in haemodialysis patients
(PLoS, 2018-12-06) Zanotto, Tobia; Mercer, Tom; van der Linden, Marietta; Traynor, Jamie P.; Petrie, Colin J.; Doyle, Arthur; Chalmers, Karen; Allan, Nicola; Price, Jonathan; Oun, Hadi; Shilliday, Ilona; Koufaki, Pelagia; Joles, Jaap A.
Background: Stage 5 chronic kidney disease patients on haemodialysis (HD) often present with dizziness and pre-syncopal events as a result of the combined effect of HD therapy and cardiovascular disease. The dysregulation of blood pressure (BP) during orthostasis may be implicated in the aetiology of falls in these patients. Therefore, we explored the relationship between baroreflex function, the haemodynamic responses to a passive orthostatic challenge, and falls in HD patients.
Baroreflex function, haemodynamic responses to an orthostatic challenge, and falls in haemodialysis patients [SP400] (Abstract)
(Oxford University Press, 2018-05-18) Zanotto, Tobia; Koufaki, Pelagia; Mercer, Tom; van der Linden, Marietta; Traynor, Jamie; Petrie, Colin; Price, Jonathan; Oun, Hadi; Shilliday, Ilona
Background: The prevalence of falls among Stage 5 chronic kidney disease (CKD-5) patients undergoing haemodialysis (HD) therapy ranges from 26.3% to 47%, and is considerably higher than in the general healthy population. In addition to traditional risk factors such as older age, frailty, comorbidity, and polypharmacy, these patients often present with dizziness and pre-syncopal events as a result of the combined effect of HD therapy and cardiovascular disease, which may contribute to an increased risk of falling. Particularly, it has been suggested that the dysregulation of blood pressure during orthostasis may play a role in the aetiology of falls in these patients. Purpose of the study: To compare the haemodynamic responses to a passive orthostatic challenge, as well as the baroreflex function, in HD patients with and without history of falls.
Being habitually active in leisure-time: Today's best buy for Public Health.
(1989) Mercer, Tom
Blood pressure variability and frailty in end-stage kidney disease
(Springer, 2024-08-10) Zanotto, Tobia; Mercer, Tom; van der Linden, Marietta; Koufaki, Pelagia
Background High blood pressure variability (BPV) is a predictor of cardiovascular events and all-cause mortality in people with end-stage kidney disease (ESKD) and a marker of aging in geriatric populations. Nevertheless, the relationship between BPV and geriatric syndromes, such as frailty, in people with ESKD is not well understood. Objective To examine the association between very short-term BPV and frailty in people with ESKD and receiving hemodialysis. Design Cross-sectional study. Setting Three dialysis units in the United Kingdom. Participants Sixty-nine people receiving hemodialysis (median age=62.0 years, interquartile range [IQR]=19.0; 52.2% male; median dialysis vintage=1.1 years, IQR=2.4). Measurements Systolic and diastolic BPV were recorded using continuous, non-invasive BP monitoring (Task Force Monitor). The very low, low, and high frequency components of BPV (VLF-BPV, LF-BPV, and HF-BPV), as well as the power spectral density (PSD-BPV) and low frequency/high frequency ratio of BPV (LF/HF-BPV) were analyzed. Frailty was evaluated using the Fried frailty phenotype. Results Twenty-six (37.7%) participants were classified as frail and 43 (62.3%) as non-frail. Frail participants had higher median systolic (2.1, IQR=5.2 mmHg2 vs. 1.1, IQR=1.6 mmHg2, p=0.002) and diastolic HF-BPV (0.9, IQR=2.3 mmHg2 vs. 0.5, IQR=1.0 mmHg2, p=0.048) compared to their non-frail counterparts. In addition, frail participants had higher median systolic VLF-BPV (3.2, IQR=12.5 mmHg2 vs. 2.0, IQR=2.4 mmHg2, p=0.012), LF-BPV (2.0, IQR=3.8 mmHg2 vs. 1.1, IQR=2.0 mmHg2, p=0.016), and PSD-BPV (6.6, IQR=27.6 mmHg2 vs. 4.5, IQR=5.9 mmHg2, p=0.005) compared to the non-frail participants. In age- and sex-adjusted logistic regression analyses, only systolic VLF-BPV (odds ratio [OR]=1.13, 95% confidence interval [CI]:1.01–1.26, p=0.035), HF-BPV (OR=1.26, 95%CI:1.01–1.57, p=0.044), and PSD-BPV (OR=1.06, 95%CI:1.01–1.12, p=0.029) were associated with increased odds of being frail. Conclusion Higher systolic BPV is associated with frailty in people receiving hemodialysis. Beat-to-beat assessments of BPV through continuous, non-invasive BP monitoring may be useful in evaluating frailty in ESKD populations.