title: Physical inactivity: a risk factor and target for intervention in renal care.
abstract: Regular physical activity is associated with an increased quality of life and reduced morbidity and mortality in the general population and in patients with chronic kidney disease (CKD). Physical activity, cardiorespiratory fitness, and muscle mass decrease even in the early stages of CKD, and continue to decrease with disease progression; notably, full recovery is generally not achieved with transplantation. The combined effects of uraemia and physical inactivity drive the loss of muscle mass. Regular physical activity benefits cardiometabolic, neuromuscular and cognitive function across all stages of CKD, and therefore provides an approach to address the multimorbidity of the CKD population. Interestingly, maintenance of muscle health is associated with renoprotective effects. Despite evidence of its benefits, physical activity and exercise management are not routinely addressed in the care of these patients. Although studies defining the optimum frequency, duration and intensity of physical activity are lacking, evidence from related fields can guide practical approaches to the care of patients with renal disease. Optimization of metabolic and nutritional status alongside promotion of physical activity is recommended. Behavioural approaches are now recognized as crucial in helping patients to adopt lifestyle changes and might prove valuable in integrating physical activity into renal care.
authors.affiliation: Department of Nephrology, University Medical Center Groningen, University of Groningen, Hanzeplein 1, 9700RB Groningen, Netherlands.
authors.forename: Dorien M
authors.initials: DM
authors.lastname: Zelle
authors.affiliation: Department of Nephrology, University Medical Center Groningen, University of Groningen, Hanzeplein 1, 9700RB Groningen, Netherlands.
authors.forename: Gerald
authors.initials: G
authors.lastname: Klaassen
authors.affiliation: Department of Rehabilitation Medicine, University Medical Center Groningen, University of Groningen, Hanzeplein 1, 9700RB Groningen, Netherlands.|Research group Healthy Ageing, Hanze University of Applied Sciences, Allied Health Care and Nursing, Groningen, Eyssoniusplein 18, 9701 DC Groningen, Netherlands.
authors.forename: Edwin
authors.initials: E
authors.lastname: van Adrichem
authors.affiliation: Department of Nephrology, University Medical Center Groningen, University of Groningen, Hanzeplein 1, 9700RB Groningen, Netherlands.
authors.forename: Stephan J L
authors.initials: SJ
authors.lastname: Bakker
authors.affiliation: Department of Epidemiology, University Medical Center Groningen, University of Groningen, Hanzeplein 1, 9700RB Groningen, Netherlands.
authors.forename: Eva
authors.initials: E
authors.lastname: Corpeleijn
authors.affiliation: Department of Nephrology, University Medical Center Groningen, University of Groningen, Hanzeplein 1, 9700RB Groningen, Netherlands.
authors.forename: Gerjan
authors.initials: G
authors.lastname: Navis
mesh_terms: D015444:Exercise; D005081:Exercise Therapy; D006801:Humans; D017410:Practice Guidelines as Topic; D011788:Quality of Life; D051436:Renal Insufficiency, Chronic / Q000150:complications / Q000378:metabolism / Q000503:physiopathology / Q000628:therapy*; D012307:Risk Factors; D057185:Sedentary Behavior