Physical Activity and Exercise in Chronic Kidney Disease

Combining exercise and nutrition in chronic kidney disease and dialysis: Can we learn from the performance nutrition of athletes?

“…38 Understanding that exercise research and kidney disease research are both notoriously difficult, it is important to recognize that the magnitude of improvements in exercise studies in people with CKD is modest or inconsistent, particularly for functional outcomes. 39 Therefore, to improve the outcomes, we must consider the research and clinical practice methods employed.…”

“…Unfortunately, many studies have been unable to achieve this which may account for the seemingly underwhelming results. As an example, the EXCITE trial 40 was clearly an impressive exercise intervention study; however, only 30% of patients met the inclusion criteria, 36% refused to participate, the workload was very low intensity (60 min per week of low intensity walking), and ultimately, only 14% of the patients in the participating clinics were able to adhere to a 6‐month walking program that was 60% below the recommended volume of aerobic exercise in most physical activity guidelines 39 . Unfortunately, the low‐volume and intensity of the exercise prescriptions, poor adherence, and high dropout rates are the norm, rather than the exception, in the CKD exercise literature, prompting the recommendation for a more individualized approach 21,41 …”

“…While many studies support the benefits of exercise in individuals with CKD, the question has been repeatedly posed “why has exercise not been incorporated into routine clinical practice?” 38 Understanding that exercise research and kidney disease research are both notoriously difficult, it is important to recognize that the magnitude of improvements in exercise studies in people with CKD is modest or inconsistent, particularly for functional outcomes 39 . Therefore, to improve the outcomes, we must consider the research and clinical practice methods employed.…”