Clinical Application of Exercise Therapy in Diabetes with Chronic Kidney Disease

  • Hisayo YokoyamaEmail author


A small number of patients with chronic kidney disease (CKD), particularly those on maintenance hemodialysis, are in the habit of exercise, and this sedentary lifestyle and poor physical fitness is associated with a high prevalence of fall-associated fracture and an increased mortality risk. However, exercise training has various therapeutic benefits in these patients. It delays the progression of microalbuminuria or CKD, increases physical fitness and strength, improves mental health, enhances dialysis efficacy, results in a better glycemic control, and reduces both cardiovascular and mortality risks.

If possible, undergoing a cardiopulmonary exercise test (CPX) before participating in an exercise program may lead to a safer and more effective training of these patients. Aerobic exercise training should be started with a low level of exercise load, and its intensity should be gradually increased along with the assessment of the patient’s perceived exertion during the sessions. Not only ensuring the safety and enough consideration toward the diabetic complications but also the involvement of exercise professionals and attractive programs are included as the key elements of the sustainability of exercise in these patients.


Intradialytic exercise Exercise test Perceived exertion 


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Copyright information

© Springer Japan 2016

Authors and Affiliations

  1. 1.Research Center for Urban Health and SportsOsaka City UniversityOsakaJapan

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