Randomized Controlled Trial of Exercise in CKD-The RENEXC Study.

Area of Science:

• Nephrology
• Exercise Physiology
• Geriatrics

Background:

• Chronic kidney disease (CKD) management often lacks home-based, clinically feasible trials for non-dialysis-dependent patients.
• Previous research on exercise interventions in CKD populations is limited, particularly for stages 3-5.

Purpose of the Study:

• To compare the effects of balance versus strength training on physical performance in CKD patients.
• To assess the impact of these exercise programs on measured glomerular filtration rate (mGFR) and albuminuria levels.

Main Methods:

• A single-center, randomized controlled trial (RCT) involving 151 CKD patients (stages 3-5).
• Participants were randomized to either balance or strength training programs for 12 months.
• Both groups engaged in 30 minutes of daily exercise, 5 days a week, including endurance, strength, or balance components, with intensity monitored by Borg's rating of perceived exertion (RPE).

Main Results:

• No significant differences in primary physical performance outcomes between strength and balance training groups.
• Both groups demonstrated significant improvements in walking distance, sit-to-stand tests, quadriceps strength, functional reach, and fine motor skills after 12 months.
• The strength training group experienced a significant 33% decrease in albuminuria, while mGFR declined similarly in both groups (1.8 ml/min per 1.73 m²).

Conclusions:

• The hypothesis that strength training is superior to balance training for physical performance was not supported.
• Twelve months of either exercise program led to significant improvements in most physical performance measures within each group.
• Strength training demonstrated a specific benefit in reducing albuminuria in CKD patients, alongside general physical performance enhancements observed in both training types.