Physical exercise in kidney disease: A commonly undervalued treatment modality

Area of Science:

• Nephrology
• Exercise Physiology
• Public Health

Background:

• Physical inactivity is a significant risk factor for numerous health disorders.
• A strong correlation exists between chronic kidney disease (CKD) and sedentary lifestyles.
• Current medical practice often prioritizes pharmacological treatments over lifestyle interventions like physical activity for CKD.

Purpose of the Study:

• To review the pathophysiological mechanisms of physical exercise's benefits in CKD.
• To discuss clinical studies and trials involving exercise interventions for CKD patients.

Main Methods:

• Narrative review of existing literature.
• Explanation of exercise's impact on pathophysiological pathways.
• Analysis of clinical trials in various stages of CKD.

Main Results:

• Exercise positively influences inflammation, oxidative stress, vascular function, immune response, and metabolism.
• In pre-dialysis CKD, exercise reduces body weight, inflammation markers, and fasting glucose, improving functional capacity and quality of life.
• In dialysis and transplant patients, exercise enhances cardiorespiratory fitness, walking capacity, and quality of life, with combined training being most effective for oxygen uptake.

Conclusions:

• Physical exercise is vital for improving inflammation, oxidative stress, vascular function, and quality of life in CKD patients, regardless of stage or treatment.
• The direct effect of exercise on kidney function remains unclear.
• Further extensive, long-term trials are necessary to ascertain exercise's impact on major clinical outcomes like mortality and cardiovascular risk.