Exercise training for adults with chronic kidney disease

Heiwe, Susanne; Jacobson, Stefan H.

doi:10.1002/14651858.cd003236.pub2

Cited by 330 publications

(319 citation statements)

References 327 publications

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“…Patients affected by end-stage renal disease (ESRD) show quite lower physical activity and exercise capacity [1,2,3] when compared to healthy individuals. Muscle strength and aerobic capacity are extremely limited in hemodialysis (HD) patients [4,5,6].…”

Section: Introductionmentioning

confidence: 99%

Dialysis Exercise Team: The Way to Sustain Exercise Programs in Hemodialysis Patients

Capitanini¹,

Lange²,

D’Alessandro

et al. 2014

Kidney Blood Press Res

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Patients affected by end-stage renal disease (ESRD) show quite lower physical activity and exercise capacity when compared to healthy individuals. In addition, a sedentary lifestyle is favoured by lack of a specific counseling on exercise implementation in the nephrology care setting. Increasing physical activity level should represent a goal for every dialysis patient care management. Three crucial elements of clinical care may contribute to sustain a hemodialysis exercise program: a) involvement of exercise professionals, b) real commitment of nephrologists and dialysis professionals, c) individual patient adaptation of the exercise program. Dialysis staff have a crucial role to encourage and assist patients during intra-dialysis exercise, but other professionals should be included in the ideal “exercise team” for dialysis patients. Evaluation of general condition, comorbidities (especially cardiovascular), nutritional status and physical exercise capacity are mandatory to propose an exercise program, in either extra-dialysis or intra-dialysis setting. To this aim, nephrologist should lead a team of specialists and professionals including cardiologist, physiotherapist, exercise physiologist, renal dietician and nurse. In this scenario, dialysis nurses play a pivotal role since they guarantee a constant and direct approach. Unfortunately dialysis staff may often lack of information and formation about exercise management while they take care patients during the dialysis session. Building an effective exercise team, promoting the culture of exercise and increasing physical activity levels lead to a more complete and modern clinical care management of ESRD patients.

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Section: Introductionmentioning

confidence: 99%

Dialysis Exercise Team: The Way to Sustain Exercise Programs in Hemodialysis Patients

Capitanini¹,

Lange²,

D’Alessandro

et al. 2014

Kidney Blood Press Res

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“…They found that the studies using aerobic or strength training or mixed aerobic and strengthening exercise as anabolic interventions were unable to consistently demonstrate beneficial anabolic effects. Two recent systematic reviews and meta-analyses of exercise training in patients on HD, by Smart and Steele 13 and Heiwe and colleagues, 14 showed that exercise training is safe and is associated with sizeable improvements in peak oxygen consumption, sympathetico-adrenal activity, physical function, and health-related quality of life. Although Heiwe and colleagues 14 reviewed outcomes evaluating muscle morphology and morphometrics, their results may not be relevant to our objectives for two reasons: first, a study that recruited participants with chronic kidney disease not on HD 15 was included in their cumulative analysis; second, several studies that we have identified as relevant were not considered relevant by Heiwe and colleagues, 14 which may have affected their evaluation of the effect of exercise on the mid-thigh muscle area.…”

mentioning

confidence: 99%

Anabolic Effect of Exercise Training in People with End-Stage Renal Disease on Hemodialysis: A Systematic Review with Meta-analysis

Sawant

House

Overend

2014

Physiotherapy Canada

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Purpose: The primary purpose of this systematic review was to evaluate the anabolic effect of exercise intervention in adults with end-stage renal disease on hemodialysis (HD). The secondary objectives were to evaluate the influences of participant characteristics and exercise parameters on changes in muscle size. Methods: Electronic databases (Cochrane, CINAHL, EMBASE, PEDro, PubMed and SCOPUS) were searched from inception to November 2012. Randomized clinical trials published in English that included adults on HD undergoing an exercise intervention where muscle mass was measured as an outcome were included in this review. Two reviewers independently selected the studies, extracted data, and assessed risk of bias within the included studies. Results were then combined by meta-analysis. The effect of exercises was determined using a standardized mean difference (SMD), expressed as Hedges' g, computed using a random effects model. Results: Seven SMDs extracted from five studies were included for final analysis. Strength training was used in all studies; one study used aerobic and mixed strength and aerobic training with two subgroups of participants. The overall effect of exercise on muscle mass was statistically significant (SMD: 0.272; 95% CI, 0.020-0.525). Conclusions: Our results confirm a small but significant effect of strengthening exercise as an anabolic intervention to increase muscle mass. Exercise training should be included in routine management of people on maintenance HD. Although current results indicate that one in nine people on HD is likely to benefit from exercise intervention, parameters influencing these results require further research.Key Words: bioelectrical impedance; computed tomography scan; dual energy x-ray absorptiometry; exercise; hemodialysis; magnetic resonance imaging; skeletal muscle. RÉ SUMÉObjectif : Cette critique systé matique visait principalement à é valuer l'effet anabolique de l'exercice chez des adultes vivant avec une insuffisance ré nale chronique au stade ultime et suivant des traitements d'hé modialyse (HD). Les objectifs secondaires consistaient à é valuer l'influence des caracté ristiques des participants et des paramè tres de l'exercice sur les changements de la taille des muscles. Mé thodes : On a effectué des recherches dans des bases de donné es é lectroniques (Cochrane, CINAHL, EMBASE, PEDro, PubMed et SCOPUS) depuis leur cré ation jusqu'en novembre 2012. On a inclus des essais cliniques randomisé s publié s en anglais et portant sur des adultes en HD suivant un programme d'exercice au cours duquel on a mesuré la masse musculaire comme ré sultat. Deux examinateurs agissant indé pendamment ont choisi les é tudes, extrait des donné es et é valué le risque de biais dans les é tudes incluses. Les ré sultats ont ensuite é té combiné s par mé ta-analyse. On a dé terminé l'effet de l'exercice au moyen d'une diffé rence moyenne normalisé e (DMN) exprimé e par la mesure g de Hedges, calculé au moyen d'un modè le à effet alé atoire. Ré sultats : Sept DMV extrai...

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“…The 2011 Cochrane review [15] assessed the effect of regular exercise training in adults with CKD and in kidney transplant recipients on several outcomes, including dietary nutrient intake and parameters of nutritional status. It emerged that physical fitness and physical functioning (defined as the ability and capacity to perform activities of daily living) is severely reduced in adults with CKD and progressively declines from the early stages of CKD to ESRD [15].…”

Section: Exercisementioning

confidence: 99%

“…It emerged that physical fitness and physical functioning (defined as the ability and capacity to perform activities of daily living) is severely reduced in adults with CKD and progressively declines from the early stages of CKD to ESRD [15]. Regular exercise training can improve arterial blood pressure control and heart rate, physical fitness walking capacity and several nutritional parameters and quality of life.…”

Section: Exercisementioning

confidence: 99%

Nutrition and Physical Activity in CKD patients

Cupisti¹,

Fumagalli²,

Vigo³

et al. 2014

Kidney Blood Press Res

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Chronic kidney disease (CKD) patients are at risk for protein-energy wasting, abnormal body composition and impaired physical capacity. These complications lead to increased risk of hospitalization, morbidity and mortality.In CKD patient as well as in healthy people, there is a close association between nutrition and physical activity. Namely, inadequate nutrient (energy) intake impairs physical performance thus favoring a sedentary lifestyle: this further contributes to loss of muscle strength and mass, which limit the quality of life and rehabilitation of CKD patients. In CKD as well as in end-stage-renal-disease patients, regular physical activity coupled with adequate energy and protein intake counteracts protein-energy wasting and related comorbidity and mortality. In summary, exercise training can positively influence nutritional status and the perception of well-being of CKD patients and may facilitate the anabolic effects of nutritional interventions.

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Exercise training for adults with chronic kidney disease

Cited by 330 publications

References 327 publications

Dialysis Exercise Team: The Way to Sustain Exercise Programs in Hemodialysis Patients

Dialysis Exercise Team: The Way to Sustain Exercise Programs in Hemodialysis Patients

Anabolic Effect of Exercise Training in People with End-Stage Renal Disease on Hemodialysis: A Systematic Review with Meta-analysis

Nutrition and Physical Activity in CKD patients

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