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The effectiveness and safety of modest exercise in Japanese patients with chronic kidney disease: a single-armed interventional study

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Abstract

Background

Poor physical ability and skeletal muscle wasting are common in chronic kidney disease (CKD) patients, who may experience a decline in daily activity and, in turn, increased mortality. The purpose of this study was to evaluate the effectiveness and safety of modest exercise in patients with stable CKD.

Methods

Forty-seven CKD patients were enrolled in a 6-month group program for aerobic and resistance exercise by self-training. Parameters of physical function and clinical laboratory markers, including renal function, were measured.

Results

The International Physical Activity Questionnaire score improved from a baseline of 36.6 ± 13.8 to 40.1 ± 14.8 after the exercise program (P < 0.001). The number of daily steps increased from 6141 ± 2620 to 7679 ± 3026 (P < 0.001). We detected significant changes in the 30-s chair stand test (from 20.7 ± 5.3 to 26.0 ± 5.9 repetitions; P < 0.001), single-foot standing test (from 53.0 ± 44.3 to 68.4 ± 43.0 s; P = 0.001) and 6-min walk (from 501.6 ± 63.8 to 528.7 ± 71.8 m; P = 0.02). Moreover, body weight, waist circumference, and blood pressure were significantly reduced. No significant deterioration was observed in the estimated glomerular filtration rate. Proteinuria significantly decreased in 21 patients.

Conclusion

Our modest exercise program improved the physical performance of CKD patients without deterioration of renal function. These results suggest that exercise rather than excess rest should be recommended for CKD patients to avoid muscle wasting.

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Acknowledgments

This study was funded by the Nagoya University Graduate School of Medicine. This study was supported in part by a Grant-in-Aid for Progressive Renal Diseases Research, Research on Rare and Intractable Disease, from the Ministry of Health, Labour and Welfare of Japan.

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Authors and Affiliations

  1. Department of Nursing, Nagoya University Graduate School of Medicine, Nagoya, Aichi, Japan

    Masami Hamada & Etsuko Kajita

  2. Department of CKD Initiatives, Nagoya University Graduate School of Medicine, Nagoya, Aichi, Japan

    Yoshinari Yasuda

  3. Department of Nephrology, Nagoya University Graduate School of Medicine, 65, Tsuruma-cho, Showa-ku, Nagoya, Aichi, 464-8550, Japan

    Sawako Kato & Shoichi Maruyama

  4. Department of Faculty of Social Welfare, Nihon Fukushi University, Mihama, Aichi, Japan

    Hiroki Arafuka

  5. Department of Endocrinology and Diabetes, Nagoya University Graduate School of Medicine, Nagoya, Aichi, Japan

    Motomitsu Goto

  6. Department of Cardiology, Banbuntane Hotokukai Hospital, Nagoya, Aichi, Japan

    Mutsuharu Hayashi

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  1. Masami Hamada
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  2. Yoshinari Yasuda
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Corresponding author

Correspondence to Shoichi Maruyama.

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Disclosure Statement

The Department of Nephrology, Nagoya University Graduate School of Medicine, reported receiving research promotion grants from Kyowa Hakko Kirin and Otsuka. The Department of Endocrinology and Diabetes, Nagoya University Graduate School of Medicine, reported receiving from AstraZeneca, Dainippon Sumitomo, Kowa, Takeda, Ono, Novo Nordisk. However, the research topics of these donation grants are not restricted. Yasuda Yoshinari belongs to Department of CKD Initiatives, Nagoya University Graduate School of Medicine endowed by MSD, Dainippon Sumitomo Pharma, Chugai Pharmaceutical Co., Ltd, Kowa Pharmaceutical Co., Ltd, Nippon Boehringer Ingelhim, Nihon Medi-Phisics, Co., Ltd. And Yasuda Yoshinari receives Manuscript fees from MSD and Astellas Phrma Inc.

Conflict of interest

The authors declare no financial support or conflict of interest.

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Hamada, M., Yasuda, Y., Kato, S. et al. The effectiveness and safety of modest exercise in Japanese patients with chronic kidney disease: a single-armed interventional study. Clin Exp Nephrol 20, 204–211 (2016). https://doi.org/10.1007/s10157-015-1147-6

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  • DOI: https://doi.org/10.1007/s10157-015-1147-6

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