Non-dialysis CKD patients can safely engage in moderate-intensity aerobic exercise

Liz Meszaros, MDLinx | July 15, 2017

One 30-minute moderate-intensity round of aerobic exercise does not impair renal function in non-dialysis chronic kidney disease (CKD) patients, regardless of disease stage, and therefore, exercise training in these patients may be safe, according to study results published in the American Journal of Physiology—Renal Physiology.


Aerobic exercise

After subjects with non-dialysis CKD used a treadmill for 30 minutes at moderate intensity, researchers found no effects on GFR via creatinine clearance (GFRCr-Cl) in any group across time.

“Exercise has been overlooked as a potential therapy in chronic kidney disease (CKD), mainly due to a lack of understanding on its safety aspects. Notably, there [are] no data on renal function after exercise in CKD considering its stages,” wrote Davi Alves de Santana, School of Physical Education and Sport, University of São Paulo, Applied Physiology & Nutrition Research Group, São Paulo, Brazil, and colleagues.

Therefore, these researchers undertook this study to assess the acute effects of a 30-minute moderate-intensity session of aerobic exercise on glomerular filtration rate (GFR) and albuminuria. They enrolled 22 non-dialysis CKD patients, and divided them into CKD stages 1 and 2 (CKD1-2) and CKD stages 3 and 4 (CKD3-4). Eleven BMI-, age-, and sex-matched healthy subjects were also included as controls.

All subjects used a treadmill at moderate intensity for 30 minutes. Dr. Alves de Santana and colleagues collected blood and urine samples before, immediately after, and up to 90 minutes post-exercise to assess creatinine and albumin, and determined GFR via creatinine clearance (GFRCr-Cl).

Compared with controls, all CKD patients had significantly lower peak oxygen uptake, and increasingly higher serum creatinine (9.6 mg/L for CKD1-2; 25.6 mg/L for CKD3-4 vs 7.5 mg/L in controls).

Over time, researchers found no within-group changes in either serum or urinary creatinine. In CKD1-2 and CKD3-4, GFRCr-Cl was decreased compared with controls (91, 24, and 122 ml/min-1/1.73 m2-1, respectively).

Importantly, they found that exercise had no effects on GFRCr-Cl in any group over time. Albuminuria was significantly higher in CKD3-4 compared with controls (297 vs 5.4 µg/min-1, respectively), but no within-group changes were seen after exercise.

“These data suggest the notion that moderate-intensity aerobic exercise training can be a safe therapeutic in the management of CKD,” these researchers concluded