Global Policy Barriers and Enablers to Exercise and Physical Activity in Kidney Care

Bennett, Paul N.; Kohzuki, Masahiro; Bohm, Clara; Roshanravan, Baback; Bakker, Stephan J. L.; Viana, João L.; MacRae, Jennifer M; Wilkinson, Thomas J; Wilund, Kenneth R.; Craenenbroeck, Amaryllis H. Van; Sakkas, Giorgos K.; Mustata, Stefan; Fowler, Kevin; McDonald, Jamie; Aleamañy, Geovana Martin; Anding, Kirsten; Avin, Keith G.; Escobar, Gabriela Leal; Gabrys, Iwona; Goth, Jill; Isnard, M.; Jhamb, Manisha; Kim, Jun Chul; Li, John Wing; Lightfoot, Courtney J; McAdams‐DeMarco, Mara; Manfredini, Fabio; Meade, Anthony; Mølsted, Stig; Parker, Kristen; Seguri-Orti, Eva; Smith, Alice C.; Verdin, Nancy; Zheng, Jing; Zimmerman, Deb; Thompson, Stephanie

doi:10.1053/j.jrn.2021.06.007

Cited by 39 publications

(26 citation statements)

References 58 publications

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“…Although local and global barriers to exercise and physical activity exist for people on PD, clinical and policy recommendations have been previously proposed to address these barriers. 6 Nephrologists and physicians can include physical function as part of the medical history, proactively discuss physical activity to modify chronic disease risk and promote participation in exercise studies. Dialysis care providers can include physical assessment in clinical pathways, develop physical activity key performance indicators, advocate for exercise professionals, seek opportunities and partnerships with universities and design activity centres in future home dialysis clinics.…”

Section: Practice Point Implementationmentioning

confidence: 99%

Section: Practice Point Implementationmentioning

confidence: 99%

“…Dialysis funders can include exercise professionals in future funding models, physical activity credits to offset medication or insurance costs, promote fitness membership in insurance packages and provide incentives for clinics that promote physical activity. 6 For LICs and LMICs, exercise and physical activity do not have to be expensive. For example, elastic fitness bands for resistance exercises are inexpensive and easy to store and can be used for frail, intermediate and high functioning PD patients for use at home.…”

Section: Practice Point Implementationmentioning

confidence: 99%

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Physical activity and exercise in peritoneal dialysis: International Society for Peritoneal Dialysis and the Global Renal Exercise Network practice recommendations

et al. 2021

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Life participation requiring physical activity and physical function is a key patient-reported outcome for people receiving peritoneal dialysis (PD). Clinician guidance is required from multidisciplinary sources regarding exercise and activity advice to address the specific needs of this group. From August 2020 through to June 2021, the Global Renal Exercise Network and the International Society for Peritoneal Dialysis reviewed the published literature and international clinical experience to develop a set of clinical practice points. A set of questions relevant to physical activity and exercise were developed from the perspective of a person receiving PD and were the basis for the practice point development. The GRADE framework was used to evaluate the quality of evidence and to guide clinical practice points. The review of the literature found sparse quality evidence, and thus the clinical practice points are generally based on the expert consensus of people receiving PD, PD exercise expert clinicians and experienced PD exercise researchers. Clinical practice points address timing of exercise and activity (post-catheter insertion, peritoneal space empty or full), the uptake of specific activities (work, sex, swimming, core exercise), potential adverse outcomes related to activity and exercise (exit site care, perspiration, cardiovascular compromise, fatigue, intra-abdominal pressure), the effect of exercise and activity on conditions of interest (mental health, obesity, frailty, low fitness) and exercise nutrition.

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Section: Practice Point Implementationmentioning

confidence: 99%

Section: Practice Point Implementationmentioning

confidence: 99%

Section: Practice Point Implementationmentioning

confidence: 99%

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Physical activity and exercise in peritoneal dialysis: International Society for Peritoneal Dialysis and the Global Renal Exercise Network practice recommendations

et al. 2021

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“…In general, people with CKD stages 1, 2, and often 3a (Glomerular Filtration Rate (GFR) < 60 to ≥45 mL/min/1.73 m 2 ) who do not have much proteinuria and who do not have other symptomatic, debilitating comorbidities (e.g., no heart or lung failure, active cancer, vasculitis, obesity, vascular insufficiency, or uncontrolled hypertension) may have an exercise capacity which is normal or, if the person chronically exercises, above normal [ 46 , 47 ]. By contrast people with CKD stage 3b, and particularly CKD stages 4 and 5 and chronic dialysis patients, which we will refer to in this paper as advanced CKD, commonly lead more physically inactive lives [ 43 , 46 , 47 , 48 , 49 ]. In general, the more severely reduced the glomerular filtration rate (GFR), the more physically inactive [ 1 , 43 , 50 ] and the more severely impaired the exercise capacity of many CKD patients [ 37 , 46 ].…”

Section: Physical Inactivity and Physical Function In Ckd Patientsmentioning

confidence: 99%

The Effect of Nutrition and Exercise on Body Composition, Exercise Capacity, and Physical Functioning in Advanced CKD Patients

2022

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Patients with stages 4 and 5 chronic kidney disease (CKD), and particularly chronic dialysis patients, commonly are found to have substantially reduced daily physical activity in comparison to age- and sex-matched normal adults. This reduction in physical activity is associated with a major decrease in physical exercise capacity and physical performance. The CKD patients are often physically deconditioned, and protein energy wasting (PEW) and frailty are commonly present. These disorders are of major concern because physical dysfunction, muscle atrophy, and reduced muscle strength are associated with poor quality of life and increased morbidity and mortality in CKD and chronic dialysis patients. Many randomized controlled clinical trials indicate that when CKD and chronic dialysis are provided nutritional supplements or undergo exercise training their skeletal muscle mass and exercise capacity often increase. It is not known whether the rise in skeletal muscle mass and exercise capacity associated with nutritional support or exercise training will reduce morbidity or mortality rates. A limitation of these clinical trials is that the sample sizes of the different treatment groups were small. The aim of this review is to discuss the effects of nutrition and exercise on body composition, exercise capacity, and physical functioning in advanced CKD patients.

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“…Prolonged time spent sedentary was associated with an increased risk of all-cause mortality in HD patients ( 13 , 14 ). Accordingly, there are growing voices to integrate physical activity into routine care among HD patients ( 15 ).…”

Section: Introductionmentioning

confidence: 99%

The Role of Physical Activity and Mortality in Hemodialysis Patients: A Review

Zhang

Wang

et al. 2022

Front. Public Health

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Available data indicated that physical activity was related to improved outcomes in hemodialysis patients. Multiple observational studies involving different cohorts have reported that increased physical activity level was associated with decreased mortality among hemodialysis patients. Therefore, promoting physical activity has become an increasingly critical and promising approach to improving cardiovascular health and clinical outcomes in hemodialysis patients. This review summarizes the published articles regarding physical activity and hemodialysis patients, focusing on mortality and strategy to promote physical activity.

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Global Policy Barriers and Enablers to Exercise and Physical Activity in Kidney Care

Cited by 39 publications

References 58 publications

Physical activity and exercise in peritoneal dialysis: International Society for Peritoneal Dialysis and the Global Renal Exercise Network practice recommendations

Physical activity and exercise in peritoneal dialysis: International Society for Peritoneal Dialysis and the Global Renal Exercise Network practice recommendations

The Effect of Nutrition and Exercise on Body Composition, Exercise Capacity, and Physical Functioning in Advanced CKD Patients

The Role of Physical Activity and Mortality in Hemodialysis Patients: A Review

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