title: The effectiveness and safety of modest exercise in Japanese patients with chronic kidney disease: a single-armed interventional study.
abstract: BACKGROUND
  Poor physical ability and skeletal muscle wasting are common in chronic kidney disease (CKD) patients, who may experience a decline in daily activity and, in turn, increased mortality. The purpose of this study was to evaluate the effectiveness and safety of modest exercise in patients with stable CKD.
  
  
  METHODS
  Forty-seven CKD patients were enrolled in a 6-month group program for aerobic and resistance exercise by self-training. Parameters of physical function and clinical laboratory markers, including renal function, were measured.
  
  
  RESULTS
  The International Physical Activity Questionnaire score improved from a baseline of 36.6 ± 13.8 to 40.1 ± 14.8 after the exercise program (P < 0.001). The number of daily steps increased from 6141 ± 2620 to 7679 ± 3026 (P < 0.001). We detected significant changes in the 30-s chair stand test (from 20.7 ± 5.3 to 26.0 ± 5.9 repetitions; P < 0.001), single-foot standing test (from 53.0 ± 44.3 to 68.4 ± 43.0 s; P = 0.001) and 6-min walk (from 501.6 ± 63.8 to 528.7 ± 71.8 m; P = 0.02). Moreover, body weight, waist circumference, and blood pressure were significantly reduced. No significant deterioration was observed in the estimated glomerular filtration rate. Proteinuria significantly decreased in 21 patients.
  
  
  CONCLUSIONS
  Our modest exercise program improved the physical performance of CKD patients without deterioration of renal function. These results suggest that exercise rather than excess rest should be recommended for CKD patients to avoid muscle wasting.
authors.affiliation: Department of Nursing, Nagoya University Graduate School of Medicine, Nagoya, Aichi, Japan.
authors.forename: Masami
authors.initials: M
authors.lastname: Hamada
authors.affiliation: Department of CKD Initiatives, Nagoya University Graduate School of Medicine, Nagoya, Aichi, Japan.
authors.forename: Yoshinari
authors.initials: Y
authors.lastname: Yasuda
authors.affiliation: Department of Nephrology, Nagoya University Graduate School of Medicine, 65, Tsuruma-cho, Showa-ku, Nagoya, Aichi, 464-8550, Japan.
authors.forename: Sawako
authors.initials: S
authors.lastname: Kato
authors.affiliation: Department of Faculty of Social Welfare, Nihon Fukushi University, Mihama, Aichi, Japan.
authors.forename: Hiroki
authors.initials: H
authors.lastname: Arafuka
authors.affiliation: Department of Endocrinology and Diabetes, Nagoya University Graduate School of Medicine, Nagoya, Aichi, Japan.
authors.forename: Motomitsu
authors.initials: M
authors.lastname: Goto
authors.affiliation: Department of Cardiology, Banbuntane Hotokukai Hospital, Nagoya, Aichi, Japan.
authors.forename: Mutsuharu
authors.initials: M
authors.lastname: Hayashi
authors.affiliation: Department of Nursing, Nagoya University Graduate School of Medicine, Nagoya, Aichi, Japan.
authors.forename: Etsuko
authors.initials: E
authors.lastname: Kajita
authors.affiliation: Department of Nephrology, Nagoya University Graduate School of Medicine, 65, Tsuruma-cho, Showa-ku, Nagoya, Aichi, 464-8550, Japan. marus@med.nagoya-u.ac.jp.
authors.forename: Shoichi
authors.initials: S
authors.lastname: Maruyama
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D001835:Body Weight; D015444:Exercise; D005260:Female; D006801:Humans; D007564:Japan; D008297:Male; D008875:Middle Aged; D011507:Proteinuria / Q000628:therapy / Q000652:urine; D051436:Renal Insufficiency, Chronic / Q000628:therapy* / Q000652:urine
keywords: Chronic kidney disease; Exercise; Physical performance