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Updated: Apr 20, 2026
Assessment of Vascular Function in Patients With Chronic Kidney Disease
Published on: June 16, 2014
Effects of a renal rehabilitation exercise program in patients with CKD: a randomized, controlled trial
Ana P Rossi1, Debra D Burris2, F Leslie Lucas3
1Department of Nephrology and Transplantation, Maine Medical Center.
Insights
A 12-week renal rehabilitation exercise program significantly improved physical function and quality of life for patients with chronic kidney disease (CKD) stages 3 and 4. This intervention offers a promising approach to enhance patient well-being.
Area of Science:
- Nephrology
- Cardiovascular Health
- Exercise Physiology
Background:
- Patients with chronic kidney disease (CKD) often experience cardiovascular disease, frequently exacerbated by physical inactivity.
- Inactivity is a significant concern for individuals with stages 3 and 4 CKD, impacting their overall health and quality of life.
Purpose of the Study:
- To evaluate the effectiveness of a structured renal rehabilitation exercise program in improving physical function and quality of life for patients with stages 3 and 4 CKD.
- To assess the impact of a 12-week exercise intervention on key physical performance metrics and health-related quality of life.
Main Methods:
- A randomized controlled trial involving 119 adults with CKD stages 3-4.
- Participants were assigned to either usual care or a renal rehabilitation program (usual care plus guided exercise twice weekly for 12 weeks).
- Physical function was measured using the 6-minute walk test, sit-to-stand test, and gait-speed test. Quality of life was assessed using the RAND 36-Item Short Form Health Survey.
Main Results:
- The renal rehabilitation group showed significant improvements in the 6-minute walk test (19% increase) and sit-to-stand test (29% increase) compared to the usual care group.
- Participants in the exercise program reported significant enhancements in RAND-36 measures, including role functioning, physical functioning, energy/fatigue levels, general health, and pain.
- The exercise regimen was well-tolerated by the participants, indicating good adherence and safety.
Conclusions:
- A 12-week renal rehabilitation exercise program effectively enhances physical capacity and quality of life in patients with stages 3 and 4 CKD.
- The study suggests that exercise interventions are beneficial for this patient population, though longer follow-up is required to assess effects on mortality.
Background And Objectives:
Patients with CKD have a high prevalence of cardiovascular disease associated with or exacerbated by inactivity. This randomized, controlled study investigated whether a renal rehabilitation exercise program for patients with stages 3 or 4 CKD would improve their physical function and quality of life.
Design, Setting, Participants, & Measurements:
In total, 119 adults with CKD stages 3 and 4 were randomized, and 107 of these patients proceeded to usual care or the renal rehabilitation exercise intervention consisting of usual care plus guided exercise two times per week for 12 weeks (24 sessions). Physical function was determined by three well established performance-based tests: 6-minute walk test, sit-to-stand test, and gait-speed test. Health-related quality of life was assessed by the RAND 36-Item Short Form Health Survey.
Results:
At baseline, no differences in self-reported level of activity, 6-minute walk test, and sit-to-stand test scores were observed between the usual care (n=48) and renal rehabilitation exercise (n=59) groups, although baseline gait-speed test score was higher in the renal rehabilitation exercise group (P<0.001). At follow-up, the renal rehabilitation exercise group but not the usual care group showed significant improvements in the 6-minute walk test (+210.4±266.0 ft [19% improvement] versus -10±219.9 ft; P<0.001), the sit-to-stand test (+26.9±27% of age prediction [29% improvement] versus +0.7±12.1% of age prediction; P<0.001), and the RAND-36 physical measures of role functioning (P<0.01), physical functioning (P<0.01), energy/fatigue levels (P=0.01), and general health (P=0.03) and mental measure of pain scale (P=0.04). The renal rehabilitation exercise regimen was generally well tolerated.
Conclusions:
A 12-week/24-session renal rehabilitation exercise program improved physical capacity and quality of life in patients with CKD stages 3 and 4. Longer follow-up is needed to determine if these findings will translate into decreased mortality rates.
