[Physical working capacity and muscle strength in chronic renal failure are improved by exercise]

Patients with chronic kidney disease (CKD) show a decline in maximal exercise capacity and muscle strength as renal function decreases. Renal anaemia, skeletal muscle dysfunction, tiredness and increasing inactivity are the major causes of this deterioration. Exercise training improves maximal exercise capacity, muscle strength and endurance in young, middle-aged and elderly patients at all stages of CKD. Preferably exercise training should be started during the predialysis stage, however, it is equally effective in dialysis patients and after renal transplantation. It has a positive effect on muscle catabolism and counteracts weight loss and malnutrition. Moreover, exercise training has positive effects on functional capacity and health related quality of life. Exercise training should be prescribed by a neph-rologist and administered by a trained nephrological physiotherapist. Exercise training is an integral part of care of the CKD patient. It not only reduces suffering but also costs, resulting in major potential benefits for the patient, the health care system and society.