Masami Hamada1, Yoshinari Yasuda2, Sawako Kato3, Hiroki Arafuka4, Motomitsu Goto5, Mutsuharu Hayashi6, Etsuko Kajita1, Shoichi Maruyama7. 1. Department of Nursing, Nagoya University Graduate School of Medicine, Nagoya, Aichi, Japan. 2. Department of CKD Initiatives, Nagoya University Graduate School of Medicine, Nagoya, Aichi, Japan. 3. Department of Nephrology, Nagoya University Graduate School of Medicine, 65, Tsuruma-cho, Showa-ku, Nagoya, Aichi, 464-8550, Japan. 4. Department of Faculty of Social Welfare, Nihon Fukushi University, Mihama, Aichi, Japan. 5. Department of Endocrinology and Diabetes, Nagoya University Graduate School of Medicine, Nagoya, Aichi, Japan. 6. Department of Cardiology, Banbuntane Hotokukai Hospital, Nagoya, Aichi, Japan. 7. Department of Nephrology, Nagoya University Graduate School of Medicine, 65, Tsuruma-cho, Showa-ku, Nagoya, Aichi, 464-8550, Japan. marus@med.nagoya-u.ac.jp.
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.
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 CKDpatients 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 CKDpatients without deterioration of renal function. These results suggest that exercise rather than excess rest should be recommended for CKDpatients to avoid muscle wasting.
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