Beneficial effects of water-based exercise in patients with chronic kidney disease

Abstract

The possible beneficial effect of regular aquatic exercise on cardiorespiratory, renal lipid parameters and oxidative stress status was studied in patients with mild to moderate renal failure. The exercise group did low-intensity aerobic exercise in the pool during a period of 12 weeks, twice a week, with sessions lasting for 30 min. Matched control participants remained sedentary. The results showed that in the exercise group all cardiorespiratory functional parameters improved and resting blood pressure lowered significantly. Proteinuria and cystatin-C were diminished significantly and glomerular filtration rate was enhanced. To evaluate the changes in oxidative stress status in the serum, products of lipid peroxidation (LPO) and serum glutathione values were measured. LPO was reduced significantly and reduced glutathione levels showed significant improvement after the exercise-conditioning programme. In the control group the data either remained the same or worsened in the same period of time. In conclusion, regular water-based exercise has beneficial effects on the cardiorespiratory, renal functional parameters and oxidative stress status in patients with moderate renal failure, and can be used in the complex rehabilitation of chronic renal failure patients, together with blood pressure control, dietary consultation, encouragement and education to prevent physical worsening and to postpone cardiovascular and renal atherosclerotic complications.

Effects of Exercise and Lifestyle Intervention on Cardiovascular Function in CKD

“…The findings demonstrated that patients with moderate CKD randomized to receive an exercise and lifestyle intervention improved CRF, body composition, diastolic function, and preserved ventriculovascular coupling. Our results are in agreement with previous reported findings from small studies (29)(30)(31)(32)(33)(34)(35) showing that exercise training is effective in improving CRF in patients with CKD. Uremic cardiomyopathy, comprising LV dilation, hypertrophy, and impaired diastolic and systolic function, is common in late stage CKD and a strong predictor of adverse cardiovascular prognosis (8).…”

Health-Risk Factors and 8-Year Incidence of Kidney Disease in Transitional Thailand: Prospective Findings From a Large National Cohort Study

“…It is consistent with previous study revealing that physical inactivity related to an increase risk of KD incidence (Stengel et al, 2003). In addition, a study in KD patients reported that regular water-based exercise (30 minutes, twice a week) associated with decrease of proteinuria and increase of glomerular filtration rate (Pechter et al, 2003).…”

Vascular Effects of Exercise Training in CKD

“…In 17 patients with mild-to-moderate CKD, aerobic water-based exercise significantly reduced lipid peroxidation products (malondialdehyde and 4-hydroxyalkenals) and increased levels of the antioxidant glutathione compared with a sedentary control group (55). Similarly, intradialytic aerobic training for 4 months reduced thiobarbituric acid reactive substance, a product of lipid peroxidation, by 38% in hemodialysis patients compared with usual care (56).…”

“…In addition to eNOS activation, ET results in more efficient antioxidative defense mechanisms (e.g., by reducing ROS production [reduction in NAD(P)H expression, less eNOS uncoupling, etc.] and increasing the expression of antioxidative enzymes and ROS scavengers [e.g., glutathione]) (9,55,56). As such, ROS-mediated breakdown of NO is prevented.…”