Abstract
BackgroundOnly a few research is available on the effects of home-based exercise training on pre-dialysis chronic kidney disease (CKD) patients. Therefore, we aimed to elucidate the effect of home-based exercise therapy on kidney function and arm and leg muscle strength in pre-dialysis CKD patients.MethodsThirty-six male stage 3–4 pre-dialysis CKD patients (age, 68.7 ± 6.8 years; estimated glomerular filtration rate (eGFR), 39.0 ± 11.6 ml/min/1.73 m2) who were being treated as outpatients were included. The subjects were randomly assigned to an exercise intervention group (Ex group: 18) and a control group (C group: 18). The Ex group wore accelerometer pedometers and were instructed to perform home-based aerobic and resistance exercises, such as brisk walking for 30 min per day, for 12 months. The C group subjects wore accelerometer pedometers but received no exercise therapy guidance; the number of steps covered during normal daily activities was recorded for the C group. The outcome measures were changes in kidney function and handgrip and knee extension muscle strength. Values at the baseline (T1) and 12 months later (T2) were compared.ResultsThere were no significant differences in baseline characteristics between the two groups; however, the C group was more physically active than the Ex group. Eight subjects dropped out, and 28 subjects (14 in each group) were included in the final analysis. Physical activity increased significantly only in the Ex group. Grip strength (F = 7.0, p = 0.01) and knee extension muscle strength (F = 14.3, p < 0.01) were found to improve only in the Ex group. Further, the changes in eGFR were not significantly different between the two groups (F = 0.01, p = 0.93).ConclusionsHome-based exercise therapy for pre-dialysis CKD patients was feasible and improved arm and leg muscle strength without affecting kidney function.Trial registrationUMIN Clinical Trials Registry (UMIN000005091). Registered 2/15/2011.
Highlights
A few research is available on the effects of home-based exercise training on pre-dialysis chronic kidney disease (CKD) patients
28 subjects were included in the final analysis (Ex group: 14; control group (C group): 14)
No difference was observed between most variables; the C group tended to be more physically active than the Ex group
Summary
A few research is available on the effects of home-based exercise training on pre-dialysis chronic kidney disease (CKD) patients. We aimed to elucidate the effect of home-based exercise therapy on kidney function and arm and leg muscle strength in pre-dialysis CKD patients. We previously reported that the physical function of pre-dialysis CKD patients declines as the disease progresses [4]. Observational studies have indicated that physical function decline is a risk factor for poor renal prognosis [6] and poor survival [7] in pre-dialysis CKD patients. Several of the previous interventional studies on exercise therapy for CKD patients including those not requiring dialysis were center-based, and there were several problems with the implementation of the programs.
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