The effects of home exercise on insulin resistant in chronic kidney disease patients

Abstract

Insulin resistance appears at an earlier stage of chronic kidney disease (CKD) and closely correlates with atherosclerosis and cardiovascular mortality. Exercise training may improve hyperinsulinemia in patients with chronic disease, but it has proven difficult to motivate many such patients to undergo exercise training chronically. We aimed to demonstrate the effect of regular home rubber band exercise on insulin resistant in patients with CKD stage 3-5.The randomized controlled trial was conducted in CKD clinic at Phramongkutklao hospital, Bangkok, Thailand, during June to December 2010. The eligible CKD stage 3-5 participants were asked to randomly assigned to do only home gentle exercise (control) or plus home resistance exercise by using rubber band (treatment) for 12 weeks. The exercise training was supervised and strictly monitored by sport scientist every four weeks. Fasting plasma glucose and insulin concentrations was performed to calculate homeostasis model assessment (HOMA). There were 21 patients in the control group (mean age 66.05±13.72 years) and 24 patients in the treatment group (mean age 66.05±13.72 years) . At the end of study, the fasting plasma glucose (-0.76±1.84 mmol/L) and HOMA-IR (-1.09±2.43) decreased significantly in the treatment group, whereas the fasting plasma glucose (0.49±1.65 mmol/L) and HOMA-IR (0.38±2.12) slightly increase significantly in the control group. In addition, there were significant different of HOMA-IR between the control group and the treatment group (1.9±1.85 vs 3.72±3.26, P= 0.031, respectively). Moreover, all patients in the treatment group did not have serious side effect from resistance exercise, but only five patients had muscle cramp. In conclusion, regular home exercise ameliorate insulin resistance without any serious adverse effects in the CKD population.