August 10, 2022

2 minute read


Disclosures: Weiner does not report any relevant financial information.

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According to the results of this study, a 12-month program of aerobic and resistance training was safe and improved physical function in older adults with chronic kidney disease.

“Exercise may reduce losses of physical function or even improve physical function in older people with CKD; however, most studies that have evaluated exercise in older people with CKD have been a modest sample size, relatively short in duration and focused on either people on dialysis or people with early stages of CKD,” Daniel E. Weiner, MD, MRS, from the department of medicine at Tufts Medical Center in Boston, and colleagues wrote.

People walking for exercise
Source: Adobe Stock

In a multicenter, parallel-group, randomized, controlled trial, researchers examined 99 adults with CKD stages Gb to G4 (mean age was 68; 62% were African American; mean eGFR 33 mL/min/1.73m2; 59% suffered from diabetes; 29% had coronary artery disease). All patients were recruited from centers in Baltimore and Boston.

The researchers randomized the patients in a 1:1 ratio to either the exercise intervention group or a health education control group. Patients in the exercise intervention group were assigned to center-based physical training three times per week for the first 6 months. Exercise consisted of aerobic and muscle-strengthening activities. Then, the patients completed the 6-month maintenance phase during which one of the weekly sessions could be carried out at home. Patients recorded exercises at home.

Patients in the health education group had weekly sessions for 6 months and then monthly sessions during the maintenance phase. The educational content consisted of healthy eating, CRF, diabetes and blood pressure management.

Researchers used maximal oxygen uptake, which was scored using treadmill tests, and distance walked in the 6-minute walk test to measure patients’ cardiorespiratory fitness and submaximal gait. at 6 and 12 months.

A total of 31 patients dropped out of the study, were lost to follow-up, or could not complete the final 12-month follow-up.

Among patients in the exercise intervention group, 59% of sessions were followed during the first 6 months. The researchers identified increased aerobic capacity among the exercise group compared to the control group at 6 months, but this finding was not maintained at 12 months. Similarly, the exercise group showed improvements in the 6-minute walk distance and in the timed get up and go test. However, the exercise group did not show improvements on the short physical performance battery.

“It should be noted that the study was not designed to detect differences in ‘hard’ clinical outcomes, such as hospitalization or death. However, the similar rates of serious adverse events between the two randomized intervention groups support the overall safety of the long-term supervised physical training program,” Weiner and colleagues wrote. They added: “In conclusion, a 12-month program of supervised aerobic and resistance exercise training in adults ≥55 years of age with stage G3b and G4 CKD is safe, feasible, and effective in improving physical performance, albeit with a higher than expected give up.”