Effects of exercise training on physical impairment, arterial stiffness and health-related quality of life in patients with chronic kidney disease: a pilot study.
BACKGROUND
Patients with chronic kidney disease (CKD) have impaired performance in physical tasks, lower health-related quality of life and high cardiovascular morbidity and mortality. Moderate intensity exercise has been shown to provide cardiovascular and metabolic benefits in healthy individuals and patients without CKD. Long-term exercise training is recommended as a vital component in the management of a number of chronic diseases. This randomized controlled pilot project examined the effects of exercise in predialysis CKD patients.


METHODS
Ten patients were randomized to 12 months of exercise (EX) and 10 to standard care (CT). We compared the difference between the two groups in physical impairment (VO(2peak) and endurance time [ET]), arterial stiffness (augmentation index [AI]) and health-related quality of life (EuroQol EQ-5D and Short Form-36 questionnaires) (all measured at baseline and 12 months).


RESULTS
The difference between EX and CT was statistically significant for VO(2peak) (3.59 ml O(2)/kg/min; 95% CI 0.92, 6.26; P = 0.01), ET (10.97 min; 95% CI 4.34, 17.59; P = 0.003) and AI (-11.7%; 95% CI -18.79, -4.61; P = 0.003). Clinically important changes were noted in EQ-5D and SF-36.


CONCLUSIONS
This study suggests that long-term exercise training improves physical impairment, arterial stiffness and health-related quality of life in patients with predialysis CKD. A larger randomized trial is required to examine the impact of exercise on markers of cardiovascular risk and quality of life in predialysis CKD patients.
Mustata
Stefan
S
Division of Nephrology, Department of Medicine, University of Calgary, Calgary, Canada. smustata@ucalgary.ca
Groeneveld
Sharon
S
Davidson
Warren
W
Ford
Gordon
G
Kiland
Kristal
K
Manns
Braden
B
D000368:Aged; D015444:Exercise / Q000502:physiology* / Q000523:psychology*; D005080:Exercise Test; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D010101:Oxygen Consumption; D010807:Physical Endurance; D010865:Pilot Projects; D011788:Quality of Life / Q000523:psychology; D051436:Renal Insufficiency, Chronic / Q000503:physiopathology* / Q000523:psychology*; D011795:Surveys and Questionnaires; D059289:Vascular Stiffness