Thomas J Wilkinson1, Mara McAdams-DeMarco2,3, Paul N Bennett4,5, Kenneth Wilund6. 1. Leicester Kidney Lifestyle Team, Department of Health Sciences, University of Leicester, Leicester, UK. 2. Department of Surgery, Johns Hopkins University School of Medicine. 3. Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland. 4. Medical Clinical Affairs, Satellite Healthcare Inc., San Jose, California, USA. 5. Faculty of Health, Deakin University, Melbourne, Victoria, Australia. 6. Department of Kinesiology and Community Health, University of Illinois at Urbana-Champaign, Champaign, Illinois, USA.
Abstract
PURPOSE OF REVIEW: Chronic kidney disease (CKD) is characterized by poor levels of physical activity which contribute to increased morbidity across the disease trajectory. The short nature, small samples, and poor methodology across most studies have failed to translate the role of exercise in CKD into its adoption as a frontline adjunct therapeutic option. This review focuses on recent advances surrounding the benefits of exercise interventions across the CKD spectrum. RECENT FINDINGS: Key recent advances in exercise studies have focused on the efficacy of novel intervention strategies across the CKD spectrum. These include high-intensity interval training, virtual reality gaming, intradialytic yoga, electrical stimulation of muscles, blood flow restriction training, and protocols combining exercise with nutritional supplementation. Research is also beginning to explore the role of prehabilitation for patients prior to dialysis and kidney transplantation. SUMMARY: Studies continue to demonstrate wide-ranging benefits of exercise across CKD; however, implementation of exercise remains scarce. Future research needs include evaluating the efficacy of larger and/or more comprehensive interventions on clinically important outcomes. It is hoped with increasing global evidence, high-quality clinical studies, and sustained clinician and patient engagement, exercise programs will become better prioritized in the nephrology field.
PURPOSE OF REVIEW: Chronic kidney disease (CKD) is characterized by poor levels of physical activity which contribute to increased morbidity across the disease trajectory. The short nature, small samples, and poor methodology across most studies have failed to translate the role of exercise in CKD into its adoption as a frontline adjunct therapeutic option. This review focuses on recent advances surrounding the benefits of exercise interventions across the CKD spectrum. RECENT FINDINGS: Key recent advances in exercise studies have focused on the efficacy of novel intervention strategies across the CKD spectrum. These include high-intensity interval training, virtual reality gaming, intradialytic yoga, electrical stimulation of muscles, blood flow restriction training, and protocols combining exercise with nutritional supplementation. Research is also beginning to explore the role of prehabilitation for patients prior to dialysis and kidney transplantation. SUMMARY: Studies continue to demonstrate wide-ranging benefits of exercise across CKD; however, implementation of exercise remains scarce. Future research needs include evaluating the efficacy of larger and/or more comprehensive interventions on clinically important outcomes. It is hoped with increasing global evidence, high-quality clinical studies, and sustained clinician and patient engagement, exercise programs will become better prioritized in the nephrology field.
Authors: Kassia S Beetham; Rathika Krishnasamy; Tony Stanton; Julian W Sacre; Bettina Douglas; Nicole M Isbel; Jeff S Coombes; Erin J Howden Journal: J Am Soc Nephrol Date: 2021-12-10 Impact factor: 10.121
Authors: Elizabeth C Lorenz; Cassie C Kennedy; Andrew D Rule; Nathan K LeBrasseur; James L Kirkland; LaTonya J Hickson Journal: Kidney Int Rep Date: 2021-06-09