The effect of regular aerobic exercise on renal function in patients with CKD: A systematic review and meta-analysis

Abstract

Objective: To evaluate the effect of regular aerobic exercise on the improvement of renal function in patients with chronic kidney disease through meta-analysis and to provide targeted exercise recommendations for patients with CKD.Methods: PubMed, Web of Science, EBSCO, China National Knowledge Infrastructure (CNKI), and other databases were searched, and randomized controlled trials on the effects of regular aerobic exercise on renal function-related indexes in patients with CKD were collected according to the inclusion and exclusion criteria. The methodological quality of the included literature was evaluated using the Cochrane evaluation tool second generation, and statistical analysis was performed using R analysis software.Results: A total of 12 randomized controlled trials (RCTs) with a total of patients with CKD were included, and the results of the meta-analysis showed that regular aerobic exercise significantly improved the estimated glomerular filtration rate SMD = 0.65, 95% CI [0.30, 1.00], serum creatinine SMD = -0.63, 95% CI [-0.86, -0.40], 24-h urine protein volume in patients with CKD SMD = -0.41, 95% CI [-0.70, -0.11], and serum urea nitrogen SMD = -0.66, 95% CI [-1.20, -0.12]. Single exercise session longer than 30 min significantly improved the estimated glomerular filtration rate in CKD patients (p < 0.01), and walking and running as exercise modalities significantly improved CKD patients’ SCr levels were significantly improved by walking and running as exercise modalities (p < 0.05), and the improvement effect was not significant when cycling was selected as an exercise modality.Conclusion: Regular aerobic exercise has a significant effect on the estimated glomerular filtration rate, serum creatinine, 24-h urine protein amount, and blood urea nitrogen in CKD patients. Aerobic exercise with a single exercise duration longer than 30 min has a more significant effect on the estimated glomerular filtration rate, and aerobic exercise by walking or running can more effectively improve the serum creatinine in CKD patients.

Renal Rehabilitation: Present and Future Perspectives

“…Recently, Ma et al reported a meta-analysis of 12 RCTs, comprising 410 patients with CKD; the results indicated that regular aerobic exercise significantly improves the estimated GFR (eGFR), and the levels of serum creatinine, daily urinary protein excretion, and serum urea nitrogen in CKD patients. Further, a single exercise session of more than 30 min was associated with significantly improved eGFR (p < 0.01), including walking and running, but not cycling, as exercise modalities were associated with significantly improved serum creatinine levels (p < 0.05) in CKD patients (Figures 2 and 3) [35]. Thus, regular aerobic exercise has beneficial effects on the eGFR (especially with durations longer than 30 min), serum creatinine (especially with walking or running as the modality), daily urinary protein excretion, and blood urea nitrogen levels in CKD patients [35].…”

Physical Exercise After Solid Organ Transplantation: A Cautionary Tale

“…In contrast to moderate-intensity exercise, strenuous exercise of long-duration and/or high intensity can negatively impact intestinal health, as it reduces intestinal blood flow and increases intestinal permeability, leading to impaired gut-barrier function, depressed immune function, and increased risk for viral and bacterial infections [ 64 , 65 ]. While in the general population evidence suggests that regular moderate-to-vigorous aerobic physical activity reduces the risk of gastrointestinal malignancies [ 66 ], diabetes [ 67 ], chronic kidney disease [ 68 , 69 ], fatty liver disease [ 70 ], and gut microbial dysbiosis [ 71 ], little is known about the impact of strenuous physical exercise on the gastrointestinal tract in SOTRs.…”

Exercise as a therapeutic intervention in chronic kidney disease: are we nearly there yet?

“…There is growing evidence for the utilisation of exercise-based therapeutic options in the role of prevention and delayed progression of CKD. Recently published research [17,18] pertaining to the potential benefits for people at this early stage in the CKD patient pathway does reinforce the need…”

“…There is growing evidence for the utilisation of exercise-based therapeutic options in the role of prevention and delayed progression of CKD. Recently published research [ 17 , 18 ] pertaining to the potential benefits for people at this early stage in the CKD patient pathway does reinforce the need to focus on commissioning exercise-based rehabilitation as part of any prevention package, as well as the keen desire for exercise-based rehabilitation for people approaching end-stage care.…”