title: Exercise training in CKD: efficacy, adherence, and safety.
abstract: BACKGROUND
  Exercise training increasingly is recommended as an important part of the management of cardiovascular disease. However, few studies have evaluated the effectiveness of exercise training in patients with chronic kidney disease (CKD), and those that have included very selective populations.
  
  
  METHODS
  Analysis of secondary outcomes of a randomized controlled trial, with participants randomly assigned to either lifestyle intervention or usual care (control).
  
  
  METHODS
  Patients with CKD stages 3 to 4 and one or more uncontrolled cardiovascular risk factor were recruited from an outpatient clinic at a large tertiary hospital.
  
  
  METHODS
  Lifestyle intervention included access to multidisciplinary care through a nurse practitioner-led CKD clinic, exercise training, and a lifestyle program. The exercise training was a 2-phased program in which participants received 8 weeks of supervised training before commencing 10 months of home-based training.
  
  
  METHODS
  Efficacy, as assessed by metabolic equivalent tasks (METs), 6-minute walk distance, Timed Get-Up-and-Go test, grip strength, and anthropomorphic measures; adherence, as assessed by self-reported physical activity; and safety, as assessed by reported serious adverse events, were recorded.
  
  
  RESULTS
  83 patients were randomly assigned and 72 patients completed follow-up testing (intervention, n=36; control, n=36). The intervention resulted in a significant improvement in METs (pre, 7.2±3.3; post, 9.7±3.6), 6-minute walk distance (pre, 485±110m; post, 539±82m), and body mass index (pre, 32.5±6.7kg/m(2); post, 31.9±7.3kg/m(2)). Reported physical activity levels significantly increased in the intervention group at 6 months, but decreased at 12 months. There were no serious adverse events related to the exercise training.
  
  
  CONCLUSIONS
  This study was not powered to evaluate the safety of exercise training on serious adverse events.
  
  
  CONCLUSIONS
  The findings from the present study suggest that an exercise program that includes a supervised and home-based training phase is effective, adhered to, and safe in patients with CKD.
authors.affiliation: Schools of Human Movement Studies, University of Queensland, Queensland, Australia; Centre for Clinical Research Excellence-Cardiovascular Disease and Metabolic Disorders, University of Queensland, Queensland, Australia.
authors.forename: Erin J
authors.initials: EJ
authors.lastname: Howden
authors.affiliation: Schools of Human Movement Studies, University of Queensland, Queensland, Australia.
authors.forename: Jeff S
authors.initials: JS
authors.lastname: Coombes
authors.affiliation: Centre for Clinical Research Excellence-Cardiovascular Disease and Metabolic Disorders, University of Queensland, Queensland, Australia.
authors.forename: Haakan
authors.initials: H
authors.lastname: Strand
authors.affiliation: Centre for Clinical Research Excellence-Cardiovascular Disease and Metabolic Disorders, University of Queensland, Queensland, Australia; Department of Renal Medicine, Princess Alexandra Hospital, Brisbane, Queensland, Australia.
authors.forename: Bettina
authors.initials: B
authors.lastname: Douglas
authors.affiliation: Centre for Clinical Research Excellence-Cardiovascular Disease and Metabolic Disorders, University of Queensland, Queensland, Australia; Department of Renal Medicine, Princess Alexandra Hospital, Brisbane, Queensland, Australia.
authors.forename: Katrina L
authors.initials: KL
authors.lastname: Campbell
authors.affiliation: Centre for Clinical Research Excellence-Cardiovascular Disease and Metabolic Disorders, University of Queensland, Queensland, Australia; Department of Renal Medicine, Princess Alexandra Hospital, Brisbane, Queensland, Australia. Electronic address: nikky.isbel@health.qld.gov.au.
authors.forename: Nicole M
authors.initials: NM
authors.lastname: Isbel
mesh_terms: D000368:Aged; D002318:Cardiovascular Diseases / Q000453:epidemiology; D005081:Exercise Therapy / Q000009:adverse effects; D005260:Female; D006801:Humans; D008019:Life Style; D008297:Male; D008875:Middle Aged; D053580:Muscle Strength / Q000502:physiology; D010349:Patient Compliance; D051436:Renal Insufficiency, Chronic / Q000503:physiopathology / Q000628:therapy*; D012307:Risk Factors; D016896:Treatment Outcome
keywords: Physical activity; aerobic exercise; cardiovascular risk; chronic kidney disease (CKD); exercise capacity; exercise training; lifestyle; modifiable risk factor; muscle strength; physical functioning; resistance training