Physical activity among children and young people with chronic kidney diseases: a scoping review

Promoting physical activity is a global initiative. However, published systematic syntheses regarding physical activity among children and young people with chronic kidney disease (CKD) are limited. The aim of this review was to determine the evidence relating to physical activity among children and young people with CKD and identify research gaps. A comprehensive search across seven databases was conducted, and two reviewers screened and synthesised the data. Fifty-seven primary studies were included. Most studies were observational, conducted in Europe and North America, and focused on kidney transplant recipients. Physical activity levels measured by various parameters, tools, and reporting methods showed children with CKD had a lower or similar percentage of physical activity participation, intensity, frequency, duration, and overall activeness compared with healthy controls. Associations between physical activity and sex, age, CKD stages, and outcomes varied in size, direction, and strength among studies. No prospective longitudinal studies have examined the associations between physical activity and CKD progression. Nor did any explicitly describe children's/carer's experience of engaging in physical activity, although five qualitative studies reported impacts and adaptations in children with different CKD stages. Most interventions described were short-term (<6 months) home-based exercise training programmes incorporating endurance, resistance, or flexibility elements. In conclusion, evidence on physical activity in children with CKD is predominantly quantitative, cross-sectional, relying on self-reported data, and focusing primarily on adolescents and kidney transplant recipients. Further research should establish more precise physical activity estimates using validated, standardised measures across CKD stages and diverse populations.