Regular low-intensity aquatic exercise improves cardio-respiratory functional capacity and reduces proteinuria in chronic renal failure patients

Pechter, Ülle; Maaroos, Jaak; Mesikepp, Siiri; Veraksitš, Alar; Ots, Mai

doi:10.1093/ndt/18.3.624

Cited by 35 publications

(26 citation statements)

References 10 publications

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“…3,4,6,8–10,22 The magnitude of change in exercise capacity was similar to that reported in patients receiving dialysis. One study reported improved 6 minute walk distance and functional mobility as measured by the get up and go test, 23 and one study reported clinically meaningful improvement in overall quality of life (the EQ-5D index) in the exercise group, and in the Role-Physical domain of the SF-36.…”

Section: Exercise Training In Ckdsupporting

confidence: 81%

Exercise in Individuals With CKD

Johansen

Painter

2012

American Journal of Kidney Diseases

232

191

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There are few studies evaluating exercise in the nondialysis chronic kidney disease (CKD) population. This review covers the rationale for exercise among patients with CKD not requiring dialysis and the effects of exercise training on physical functioning, progression of kidney disease, and cardiovascular risk factors. In addition, we address the issue of the risk of exercise and make recommendations for implementation of exercise in this population. Evidence from uncontrolled studies and from small randomized controlled trials shows that exercise training results in improved physical performance and functioning among patients with CKD. In addition, although there are no studies examining cardiovascular outcomes, several studies suggest that cardiovascular risk factors such as hypertension, inflammation, and oxidative stress, may be improved with exercise training in this population. Although the current literature does not allow for definitive conclusions about whether exercise training slows the progression of kidney disease, no study has reported worsening of kidney function as a result of exercise training. In the absence of guidelines specific to the CKD population, recent guidelines developed for older individuals and patients with chronic disease should be applied to the CKD population. In sum, exercise appears to be safe in this patient population if begun at moderate intensity and increased gradually. Indeed, the evidence suggests that the risk of remaining inactive is higher. Patients should be advised to increase their physical activity when possible and referred to physical therapy or cardiac rehabilitation programs when appropriate.

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Section: Exercise Training In Ckdsupporting

confidence: 81%

Exercise in Individuals With CKD

Johansen

Painter

2012

American Journal of Kidney Diseases

232

191

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“…A substantial body of evidence showed the renoprotective effects of the physical exercise in diabetic nephropathy [15] and chronic kidney disease [9]. Physical exercise has a positive influence on physical capacity, hypertension, left ventricular function, lipid metabolism and oxidative status [21, 28]. Coelho et al showed that physical training performed before the onset of chronic kidney disease is capable of improving oxidative stress parameters, possibly by reducing oxidant production [9].…”

Section: Discussionmentioning

confidence: 99%

Effect of Regular Exercise on the Histochemical Changes of D-Galactose-Induced Oxidative Renal Injury in High-Fat Diet-Fed Rats

Park

Kim

Jin

et al. 2013

Acta Histochem. Cytochem

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Renal lipid accumulation exhibits slowly developing chronic kidney disease and is associated with increased oxidative stress. The impact of exercise on the obese- and oxidative stress-related renal disease is not well understood. The purpose of this study was to investigate whether a high-fat diet (HFD) would accelerate d-galactose-induced aging process in rat kidney and to examine the preventive effect of regular exercise on the obese- and oxidative stress-related renal disease. Oxidative stress was induced by an administration of d-galactose (100 mg/kg intraperitoneally injected) for 9 weeks, and d-galactose-treated rats were also fed with a high-fat diet (60% kcal as fat) for 9 weeks to induce obesity. We investigated the efficacy of regular exercise in reducing renal injury by analyzing Nε-carboxymethyllysine (CML), 8-hydroxygluanine (8-OHdG) and apoptosis. When rats were fed with a HFD for 9 weeks in d-galactose-treated rats, an increased CML accumulation, oxidative DNA damage and renal podocyte loss were observed in renal glomerular cells and tubular epithelial cells. However, the regular exercise restored all these renal changes in HFD plus d-galactose-treated rats. Our data suggested that long-term HFD may accelerate the deposition of lipoxidation adducts and oxidative renal injury in d-galactose-treated rats. The regular exercise protects against obese- and oxidative stress-related renal injury by inhibiting this lipoxidation burden.

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“…The interaction between all these phenomena promotes the activation of a number of intracellular events, in particular the excessive production of ROS (Vaziri, 2004), which has a direct relationship with the progression of CKD (Shah et al, 2007). Therefore, the formation of ROS is directly involved in the pathophysiology of the disease (Mandal et al, 2007) and evidence indicates that physical exercise can be an important agent in the progression (Coelho et al, 2010) and treatment in CKD (Pechter, 2003;Adams et al, 2005;Moinuddin and Leehey, 2008).…”

Section: Discussionmentioning

confidence: 99%

“…According to Pechter (2003) and Moinuddin and Leehey (2008), exercise conditioning has been shown to have a positive influence on physical capacity, hypertension, left ventricular function, lipid and glucose metabolism, oxidative status, anemia, and quality of life in CKD patients and patients on renal replacement therapy. A recent study conducted in our laboratory (Coelho et al, 2010) has shown that physical training performed before the onset of renal lesion is capable of improving oxidative stress parameters, possibly by reducing oxidant production without altering renal function and the antioxidant defense system.…”

Section: Introductionmentioning

confidence: 99%