Influence of exercise training on diabetic kidney disease: A brief physiological approach

Abstract

Sedentary lifestyle is associated with increased incidence of diabetes mellitus, whereas exercise training improves metabolic control and therefore may contribute to prevention of various chronic complications. Diabetic kidney disease is the most common microvascular complication of diabetes mellitus, and is associated with increased mortality from cardiovascular disease in diabetic patients. The literature highlights oxidative stress, renal inflammation, and activation of the renin-angiotensin-aldosterone system as the main pathophysiological mechanisms underlying tissue damage, extracellular matrix accumulation, and renal function deficit. Unfortunately, although the benefits of exercise training on cardiovascular diseases are well established, their impact on the pathophysiological mechanisms involved in the development and progression of diabetic kidney disease is not well understood. In addition, standardization of experimental models and physical rehabilitation programs in diabetic kidney disease are scarce. In this article, we present a brief review of the pathogenesis and pathophysiological mechanisms of diabetic kidney disease,and bring to light the latest findings in the literature on the impact of exercise training on diabetic kidney disease progression. Impact statement Diabetic kidney disease (DKD) is associated with increased mortality in diabetic patients and has a negative impact on public health. The identification of potential therapies that help the management of DKD can contribute to the improvement of health and quality of life of patients. Thus, this paper is timely and relevant because, in addition to presenting a concise review of the pathogenesis and major pathophysiological mechanisms of DKD, it addresses the most recent findings on the impact of exercise training on this disease. Thus, since non-pharmacological interventions have gained increasing attention in the fight against chronic diseases, this paper appears as an important tool to increase knowledge and stimulate innovative research on the impact of exercise on kidney disease.

Effect of Exercise on Health-Related Quality of Life in Patients with End-Stage Renal Disease

“…Walking, running, cycling, rowing, and swimming are all examples of low-impact exercise. There are numerous health benefits to doing this, including higher insulin sensitivity (IS), greater mitochondrial density, increased levels of antioxidant enzymes in the body, improved lung and immune system performance, and increased cardiac output [13]. Patients with chronic diseases benefit from AEs because they lower their blood pressure (BP) and increase their maximum oxygen intake.…”

“…In addition to lowering glycated haemoglobin levels, it has been linked to improvements in CV, body mass, physical function, glycaemic control, insulin sensitivity, blood pressure, and lipid profiles. Comparatively, it has a lower risk of hypoglycaemia and blood glucose fluctuations [13]. In order to help patients achieve functional independence, the RE is designed to include activities and context-oriented practice in areas that are important to each patient.…”

“…With CE, health and general cardiovascular benefits can be optimised while minimising risk factors associated with sedentary lifestyles. Because of this, it leads to better blood pressure regulation as well as lower insulin and glucose levels, glycated haemoglobin, visceral adipose tissue, and microalbuminuria [13].…”

“…Exercises that improve balance and save you from falling include balance training. If you want to walk backwards or heel-toe in a straight line, you can do so [13].…”

“…With AE, you will have better IS and less IR. RE also lowered blood glucose levels, indicating that it could be a viable option for diabetic patients looking to improve their glycaemic control [13]. Muscle tissue insensitivity is the major source of IR, which is a common symptom of uraemia regardless of the kind of renal illness present.…”