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Exercising Shows Benefit for Chronic Kidney Disease

Low-intensity home exercise program improves physical performance in dialysis patients…

Heart disease is the leading cause of death in patients with chronic kidney disease. Patients with chronic kidney disease have reduced capacity for exercise due to their conditions.

Sharlene Greenwood, MD, and her colleagues examined the effect of 12 months of exercise training on kidney function and measures of heart disease risk in patients with progressive chronic kidney disease stages 3-4. In the study, 20 patients were randomized to a rehabilitation group that received exercise training 3 times per week or standard care as the control. A total of 18 participants completed the study (8 from the rehab group and 10 from the control group).

Researchers found that after the 12-month study of exercise-based rehabilitation, there was a significantly slowed rate of the kidney function decline and improved cardiorespiratory fitness compared with standard of care. “Exercised-based rehabilitation has the potential to be a kidney-protective therapy for patients with progressive stages 3-4 CKD, and larger study groups are planned for future exploration,” said Dr. Greenwood.

In another study, Francesca Mallamaci MD and her colleagues tested the effectiveness of a low intensity, easy-to-implement, home exercise program on physical performance in dialysis patients. For this trial, they recruited 151 patients to follow the cadence of an inexpensive metronome while walking, while 146 patients remained with their normal physical activity.

After 6 months, performance in a 6-minute walking test improved in the exercise group, but remained unchanged in the control group. A ‘sit to stand’ test improved in the exercise group but not the control. The researchers concluded that a personalized low-intensity home exercise program improves physical performance in dialysis patients. “The simplicity and adaptability of the program make it suitable to the needs of high-risk population such as the dialysis population.”

These studies do have limitations in such that adherence to the regimens was unable to be measured, and the differing inclusion criteria lead to variability in patient populations. However, this evidence further supports the idea of exercise benefiting patient populations with chronic diseases, even so severe as chronic kidney disease.

Practice Pearls:

  • Exercise-based rehabilitation showed significantly slowed rate of the kidney function decline and improved cardiorespiratory fitness compared with standard of care
  • A personalized low-intensity home exercise programs improves physical performance in dialysis patients
  • Studies show simple exercises can help improve the health of patients with kidney disease

S.Greenwood; F. Mallamaci; American Society of Nephrology. Exercise Provides Clear Benefits for Patients with Chronic Kidney Disease.” ASN Kidney Week 2014. 15 Nov. 2014.