title: The role of exercise training in the management of chronic kidney disease.
abstract: OBJECTIVE
  In this review, we summarize recent studies of exercise interventions in chronic kidney disease (CKD), potential benefits, discuss barriers to implementation and make practical recommendations for incorporating exercise training into the care of patients with CKD.
  
  
  RESULTS
  Interventions targeting increased fitness and physical activity are effective and may have multiple potential benefits. Recommendations regarding physical activity advice have been incorporated into the recent update of the KDIGO CKD guidelines, which suggest that patients perform 30 min of moderate intensity exercise on most days of the week. Exercise as simple, popular and inexpensive as walking appears to be associated with significant health benefits. More vigorous exercise requires increased supervision but can be safely prescribed to patients with a broad range of comorbidities and may be associated with greater gains in health.
  
  
  CONCLUSIONS
  Physical activity, cardiorespiratory fitness and muscle function are low in patients with CKD. A sedentary lifestyle has been associated with increased mortality, morbidity and the risk factors that drive progression of both kidney and cardiac disease. There is much to learn about the benefits of different modalities of exercise but the time has come to routinely prescribe exercise interventions as part of standard nephrological care.
authors.affiliation: aInstitute for Exercise and Environmental Medicine, University of Texas Southwestern Medical Center at Dallas, Dallas, Texas bSchool of Human Movement and Nutrition Sciences, University of Queensland, Queensland cDepartment of Renal Medicine, University of Queensland at Princess Alexandra Hospital, Brisbane, Australia.
authors.forename: Erin J
authors.initials: EJ
authors.lastname: Howden
authors.forename: Jeff S
authors.initials: JS
authors.lastname: Coombes
authors.forename: Nicole M
authors.initials: NM
authors.lastname: Isbel
mesh_terms: D000818:Animals; D002318:Cardiovascular Diseases / Q000503:physiopathology / Q000517:prevention & control* / Q000628:therapy; D015444:Exercise / Q000502:physiology*; D006801:Humans; D007668:Kidney / Q000503:physiopathology*; D010809:Physical Fitness / Q000502:physiology*; D051436:Renal Insufficiency, Chronic / Q000503:physiopathology* / Q000628:therapy*; D012307:Risk Factors