12-weeks combined resistance and aerobic training confers greater benefits than aerobic alone in non-dialysis CKD.

There is a growing consensus that chronic kidney disease (CKD) patients should engage in regular exercise, but there is a lack of formal guidelines. In this report, we determined whether combined aerobic and resistance exercise would elicit superior physiological gains, in particular muscular strength, compared to aerobic training alone in non-dialysis CKD. Non-dialysis CKD patients stage 3b-5 were randomly allocated to aerobic exercise (AE, n=21; 9 males; median age 63years [IQR, 58-71]; median eGFR 24[IQR, 20-30] mL/min/1.73m2) or combined exercise (CE, n=20, 9 males, median age 63years [IQR, 51-69], median eGFR 27[IQR, 22-32] mL/min/1.73m2), preceded by a 6-week run in control period. Patients then underwent 12-weeks of supervised AE (treadmill, rowing or cycling exercise) or CE training (as AE plus leg extension and leg press exercise) performed 3x/week. Outcome assessments of knee extensor muscle strength, quadriceps muscle volume, exercise capacity and central haemodynamics were performed at baseline, following the 6-week control period and at the end of the intervention. AE and CE resulted in significant increases in knee extensor strength of 1619% (P=0.001) and 4837% (P<0.001) respectively, which were greater after CE (P=0.02). AE and CE resulted in 57% (P=0.04) and 97% (P<0.001) increases in quadriceps volume respectively (P<0.001) which was greater after CE (P=0.01). Both AE and CE increased distance walked in ISWT (2844m; P=0.01 and 3245m P=0.01) respectively. In non-dialysis CKD, the addition of resistance exercise to aerobic exercise confers greater increases in muscle mass and strength than aerobic exercise alone.