Abstract
BackgroundThe prevalence of osteopenia and osteoporosis is higher in patients with chronic kidney disease than that in the general population. Although physical exercise prevents bone loss in hemodialysis (HD) patients, previous studies have not focused on peritoneal dialysis (PD) patients. Therefore, we aimed to evaluate the effects of home-based exercise on bone mineral density (BMD) in patients with PD.MethodsStable outpatients undergoing PD were randomly assigned to the intervention group (n = 26; male, 20; median age, 66 years) or usual-care group (n = 27; male, 21; median age, 64 years). Patients in the intervention group performed home-based exercises (resistance exercise, stretching, and aerobic exercise such as walking) for 6 months, whereas those in the usual-care group performed stretching and their usual physical activity. Based on dual X-ray absorptiometry, the primary outcomes were the BMD data of the lumbar spine and proximal femoral neck. Secondary outcomes included physical function and physical activity. Pre- and post-intervention values were compared.ResultsThere was no significant within-group change in the BMD of the lumbar spine, femoral neck, and hip after 6 months of the exercise program. The intervention group had significantly improved 30-s chair-stand test, 6-min walk test, and physical activity results.ConclusionsHome-based exercises in patients with PD did not improve BMD at any of the sites evaluated. Improvement in physical function and physical activity may reduce the risk of falls in patients with PD.Trial registrationUMIN Clinical Trials Registry, UMIN000041678. Registered September 4, 2020; retrospectively registered.
Highlights
The prevalence of osteopenia and osteoporosis is higher in patients with chronic kidney disease than that in the general population
peritoneal dialysis (PD) modality was provided as continuous ambulatory PD (CAPD), automated PD (APD), and CAPD+APD
The exercise protocols resulted in significant improvement in physical function and physical activity in the intervention group compared with the usual-care group
Summary
The prevalence of osteopenia and osteoporosis is higher in patients with chronic kidney disease than that in the general population. Physical exercise prevents bone loss in hemodialysis (HD) patients, previous studies have not focused on peritoneal dialysis (PD) patients. We aimed to evaluate the effects of home-based exercise on bone mineral density (BMD) in patients with PD. Osteoporosis and osteopenia are common complications in chronic kidney disease (CKD) patients [1]. Several previous studies indicated that resistance or multicomponent exercises positively influence bone mineral density (BMD) and bone turnover in individuals without CKD [14,15,16]. Several studies on hemodialysis (HD) patients have reported that resistance exercise can increase BMD [18]. Whether exercise affects BMD in peritoneal dialysis (PD) patients remains unclear. Applying a more feasible method of home-based exercise is necessary
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