Effects of exercise training on physical impairment, arterial stiffness and health-related quality of life in patients with chronic kidney disease: a pilot study
Patients with chronic kidney disease (CKD) have impaired performance in physical tasks, lower health-related quality of life and high cardiovascular morbidity and mortality. Moderate intensity exercise has been shown to provide cardiovascular and metabolic benefits in healthy individuals and patients without CKD. Long-term exercise training is recommended as a vital component in the management of a number of chronic diseases. This randomized controlled pilot project examined the effects of exercise in predialysis CKD patients.
Ten patients were randomized to 12 months of exercise (EX) and 10 to standard care (CT). We compared the difference between the two groups in physical impairment (VO2peak and endurance time [ET]), arterial stiffness (augmentation index [AI]) and health-related quality of life (EuroQol EQ-5D and Short Form-36 questionnaires) (all measured at baseline and 12 months).
The difference between EX and CT was statistically significant for VO2peak (3.59 ml O2/kg/min; 95% CI 0.92, 6.26; P = 0.01), ET (10.97 min; 95% CI 4.34, 17.59; P = 0.003) and AI (−11.7%; 95% CI −18.79, −4.61; P = 0.003). Clinically important changes were noted in EQ-5D and SF-36.
This study suggests that long-term exercise training improves physical impairment, arterial stiffness and health-related quality of life in patients with predialysis CKD. A larger randomized trial is required to examine the impact of exercise on markers of cardiovascular risk and quality of life in predialysis CKD patients.
KeywordsArterial stiffness Chronic kidney disease Exercise capacity Exercise training Health-related quality of life Physical impairment
- 26.Sato Y, Nagasaki M, Nakai N, Fushimi T (2003) Physical exercise improves glucose metabolism in lifestyle-related diseases. Exp Biol Med (Maywood) 228:1208–1212Google Scholar
- 33.National Kidney Foundation (2005) K/DOQI Clinical practice guidelines for cardiovascular disease in dialysis patients. Am J Kidney Dis 45(Suppl 3):S1–S153Google Scholar
- 35.Chen CH, Nevo E, Fetics B et al (1997) Estimation of central aortic pressure waveform by mathematical transformation of radial tonometry pressure. Validation of generalized transfer function. Circulation 95:1827–1836Google Scholar
- 36.Canadian Agency for Drugs and Technologies in Health (2006) Guidelines for the economic evaluation of health technologies: Canada, 3rd edn. OttawaGoogle Scholar
- 51.Nonoyama ML, Brooks D, Ponikvar A et al. (2010) Exercise program to enhance physical performance and quality of life of older hemodialysis patients: a feasibility study. Int Urol Nephrol Mar 7 [Epub ahead of print]Google Scholar
- 52.Segura-Orti E, Kouidi E, Lison JF (2009) Effect of resistance exercise during hemodialysis on physical function and quality of life: randomized controlled trial. Clinic Nephrol 71:527–537Google Scholar