2021
DOI: 10.1152/ajprenal.00437.2020
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Exercise intolerance in kidney diseases: physiological contributors and therapeutic strategies

Abstract: Exertional fatigue, defined as the overwhelming and debilitating sense of sustained exhaustion that impacts the ability to perform activities of daily living, is highly prevalent in chronic kidney disease (CKD) and end-stage renal disease (ESRD). Subjective reports of exertional fatigue are paralleled by objective measurements of exercise intolerance throughout the spectrum of the disease. The prevalence of exercise intolerance is clinically noteworthy, as it leads to increased frailty, worsened quality of lif… Show more

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Cited by 48 publications
(43 citation statements)
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“…Exercise intolerance appears as an important feature of CKD that is present even in patients with early CKD stages and rises exponentially with the progression to advanced stages and end-stage kidney disease [3]. Exercise intolerance was previously shown to be closely correlated with reduced QOL [3] and to be independently associated with cardiovascular events and death in this population [4][5][6].…”
Section: Introductionmentioning
confidence: 94%
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“…Exercise intolerance appears as an important feature of CKD that is present even in patients with early CKD stages and rises exponentially with the progression to advanced stages and end-stage kidney disease [3]. Exercise intolerance was previously shown to be closely correlated with reduced QOL [3] and to be independently associated with cardiovascular events and death in this population [4][5][6].…”
Section: Introductionmentioning
confidence: 94%
“…Several factors have been suggested to affect the complex associations between CKD and associated QOL decrease, including significant changes in physical and mental functioning that lead to a vicious cycle of inactivity, deconditioning, social isolation, and depression [2]. Exercise intolerance appears as an important feature of CKD that is present even in patients with early CKD stages and rises exponentially with the progression to advanced stages and end-stage kidney disease [3]. Exercise intolerance was previously shown to be closely correlated with reduced QOL [3] and to be independently associated with cardiovascular events and death in this population [4][5][6].…”
Section: Introductionmentioning
confidence: 99%
“…As long as the activity intensity levels remain light to moderate, aerobic metabolism effectively matches the energy demand [36]. High intensity exercise, though, is limited by the capacity of aerobic metabolism and often results in VO 2 rising to its most tolerable limit, due to symptom-related fatigue that causes the individual to stop the activity [37].…”
Section: Cardiopulmonary Exercise Testingmentioning
confidence: 99%
“…Furthermore, in patients with chronic respiratory disorders, mechanical constrains of ventilation is another important cause of exercise limitation, since produced respiratory discomfort may limit exercise capacity before actual physiological limitation occurs [39]. Exercise intolerance is highly prevalent in CKD and is associated with increased frailty, worsened quality of life, and high risk of hospitalization and mortality [37]. The mechanisms of exercise intolerance in CKD appear to be a complex interaction between central and peripheral factors, including kidney disease-related metabolic derangements, cardiac and pulmonary dysfunction, altered physiologic responses to oxygen consumption, vascular derangement, abnormal neurocirculatory control, and sarcopenia.…”
Section: Cardiopulmonary Exercise Testingmentioning
confidence: 99%
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