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Advances in exercise therapy in pre-dialysis CKD, hemodialysis, peritoneal dialysis and kidney transplantation

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journal contribution
posted on 25.06.2020, 13:00 by Thomas Wilkinson, Mara McAdams-Demarco, Paul Bennett, K Wilund

Purpose of review

Chronic kidney disease (CKD) is characterized by poor levels of physical activity which contribute to increased morbidity across the disease trajectory. The short nature, small samples, and poor methodology across most studies have failed to translate the role of exercise in CKD into its adoption as a frontline adjunct therapeutic option. This review focuses on recent advances surrounding the benefits of exercise interventions across the CKD spectrum.

Recent findings

Key recent advances in exercise studies have focused on the efficacy of novel intervention strategies across the CKD spectrum. These include high-intensity interval training, virtual reality gaming, intradialytic yoga, electrical stimulation of muscles, blood flow restriction training, and protocols combining exercise with nutritional supplementation. Research is also beginning to explore the role of prehabilitation for patients prior to dialysis and kidney transplantation.

Summary

Studies continue to demonstrate wide-ranging benefits of exercise across CKD; however, implementation of exercise remains scarce. Future research needs include evaluating the efficacy of larger and/or more comprehensive interventions on clinically important outcomes. It is hoped with increasing global evidence, high-quality clinical studies, and sustained clinician and patient engagement, exercise programs will become better prioritized in the nephrology field.

Funding

National Institutes of Health (NIH): R01AG055781, R01DK120518, and R01DK114074.

History

Citation

Current Opinion in Nephrology and Hypertension: September 2020 - Volume 29 - Issue 5 - p 471-479 doi: 10.1097/MNH.0000000000000627

Author affiliation

Department of Health Sciences

Version

AM (Accepted Manuscript)

Published in

Current Opinion in Nephrology and Hypertension

Volume

29

Issue

5

Pagination

471-479

Publisher

Lippincott, Williams & Wilkins

issn

1062-4821

eissn

1473-6543

Acceptance date

18/06/2020

Copyright date

2020

Available date

01/09/2021

Language

en