Related Experiment Video
Updated: Jul 5, 2025
5/6 Nephrectomy Using Sharp Bipolectomy Via Midline Laparotomy in Rats
Published on: April 4, 2025
Exercise for patients with chronic kidney disease: from cells to systems to function
Jared M Gollie1,2, Alice S Ryan3,4, Sabyasachi Sen5,6
1Research and Development Service, Washington DC Veterans Affairs Medical Center, Washington, District of Columbia, United States.
Insights
Exercise benefits adults with chronic kidney disease (CKD). This review details how exercise training impacts cellular, systemic, and whole-body functions, improving health and function in CKD patients.
Area of Science:
- Nephrology
- Exercise Physiology
- Cellular Biology
Background:
- Chronic kidney disease (CKD) affects 800 million adults globally, presenting complex pathophysiology and management challenges.
- Key risk factors include diabetes, hypertension, age, obesity, diet, inflammation, and inactivity, leading to secondary complications like cardiovascular disease.
- CKD exacerbates obesity and inflammation, impairing cellular homeostasis and reducing health and functional capacity.
Purpose of the Study:
- To comprehensively review the effects of exercise training in patients with CKD.
- To examine exercise adaptations at the cellular (vascular endothelial progenitor cells), systemic (cardiovascular, musculoskeletal, neural), and whole-body (physical function, frailty, fatigability) levels.
Main Methods:
- This is a review article, synthesizing existing research on exercise interventions in CKD.
- The review analyzes data from cellular, systemic, and whole-body perspectives.
Main Results:
- Exercise training demonstrates protective benefits for health and function in aging individuals, including those with CKD.
- Accumulating data support exercise implementation for promoting health and function in CKD patients.
- A comprehensive description of exercise responses and adaptations in CKD is currently lacking.
Conclusions:
- Exercise training positively impacts vascular endothelial progenitor cells, cardiovascular, musculoskeletal, and neural factors in CKD patients.
- Exercise improves physical function, reduces frailty, and mitigates fatigability in individuals with CKD.
- Further understanding of exercise's multifaceted effects is crucial for optimizing CKD management.
Abstract:
Chronic kidney disease (CKD) is among the leading causes of death and disability, affecting an estimated 800 million adults globally. The underlying pathophysiology of CKD is complex creating challenges to its management. Primary risk factors for the development and progression of CKD include diabetes mellitus, hypertension, age, obesity, diet, inflammation, and physical inactivity. The high prevalence of diabetes and hypertension in patients with CKD increases the risk for secondary consequences such as cardiovascular disease and peripheral neuropathy. Moreover, the increased prevalence of obesity and chronic levels of systemic inflammation in CKD have downstream effects on critical cellular functions regulating homeostasis. The combination of these factors results in the deterioration of health and functional capacity in those living with CKD. Exercise offers protective benefits for the maintenance of health and function with age, even in the presence of CKD. Despite accumulating data supporting the implementation of exercise for the promotion of health and function in patients with CKD, a thorough description of the responses and adaptations to exercise at the cellular, system, and whole body levels is currently lacking. Therefore, the purpose of this review is to provide an up-to-date comprehensive review of the effects of exercise training on vascular endothelial progenitor cells at the cellular level; cardiovascular, musculoskeletal, and neural factors at the system level; and physical function, frailty, and fatigability at the whole body level in patients with CKD.
Related Concept Videos
01:27Dialysis
Acute kidney injury develops suddenly and can be caused by pre-renal causes (e.g., hypovolemia, shock), intrinsic renal causes (e.g., acute tubular necrosis), or post-renal causes (e.g., urinary obstruction). In contrast, chronic renal failure progresses gradually over time and is often...
01:15Renal Drug Excretion: Overview
A nephron consists of two primary structures: the renal corpuscle and the renal tubule. The renal corpuscle contains the glomerulus, a network of capillaries where the first step of renal excretion, glomerular filtration, occurs. Blood pressure forces water, ions, and small molecules...
01:10Nephrons
01:17Factors Affecting Renal Clearance: Renal Impairment
One condition associated with renal failure is uremia. Uremia is characterized by impaired glomerular filtration and fluid accumulation in the body. This condition hinders the renal clearance of drugs, resulting in drug accumulation and potential...
01:13Introduction to Urinary System
The kidneys are bean-shaped organs located in the retroperitoneal space, on either side of the vertebral column, between the T12 and L3 vertebrae. They are partially protected by the rib cage and surrounded by perirenal fat, which provides cushioning. They are responsible for urine formation and play critical roles in regulating blood pressure, electrolyte levels, and hormone production. The ureters...
01:20Renal Corpuscle
Glomerulus: Structure and Function
The glomerulus is a tiny, intricate network of capillaries located at the beginning of the nephron. It's enveloped by the Bowman's capsule and receives its blood supply from an afferent arteriole, which divides into numerous...