Exercise evaluation of children with end-stage renal disease.

The use of exercise testing in the assessment and management of various pediatric disorders has increased significantly during the past three decades. With age-appropriate equipment and exercise protocols, a well-trained and enthusiastic staff can evaluate patients as young as 3 to 4 years of age. Pediatric exercise testing may be conducted using either a cycle ergometer or a treadmill. The decision of which method to use is based on the parameters to be evaluated during the test, physical stature of the child, administrator preference, and availability of equipment in the laboratory. For children with renal disease, who are often short and may have poor leg muscle mass, the treadmill is used most often. The exercise testing protocols should use slow initial speeds and no grade, increase in small increments, and have stages of 1 to 2 minutes' duration. The benefits of testing in children with renal disorders include its ability to provide valuable information regarding the overall functional capacity of the patient, efficacy of pharmacological or surgical interventions, and outcome of rehabilitation programs.