Why the study?
Clustering of risk factors leads to elevated CVD risk across the trajectory of CKD and transplantation, motivating an evaluation of physical activity and exercise interventions for cardiorenal health.
Does physical activity and exercise intervention improve cardiorespiratory fitness and prevent or attenuate cardiorenal decline and mortality across the spectrum of chronic kidney disease?
Does physical activity and exercise intervention improve cardiorespiratory fitness and prevent or attenuate cardiorenal decline and mortality across the spectrum of chronic kidney disease?
This narrative review demonstrates that physical activity and exercise interventions across the chronic kidney disease spectrum consistently improve cardiorespiratory fitness and attenuate cardiovascular and renal risk factors, though large-scale RCTs with hard clinical outcomes and routine clinical implementation remain needed.
Answers are grounded in this paper and cite their sources.
PA interventions merit integration into CKD care to curb rising CVD risk; extends evidence for cardiorenal benefits of exercise.
Clustering of traditional and kidney-specific risk factors leads to elevated cardiovascular disease (CVD) risk across the trajectory of chronic kidney disease (CKD) and transplantation. As kidney function declines, the prevalence of CVD, cardiovascular events, and mortality increases. This review considers recent evidence for the association between physical activity (PA) and exercise and cardiorenal health, and the effectiveness of interventions for the prevention and management of cardiorenal decline across the CKD spectrum. Evidence supports a beneficial dose-response effect of PA in the prevention of incident CKD, and growing evidence in prevalent CKD patients for the attenuation of kidney function decline, and a reduction in CVD risk, morbidity, and mortality. Broadly speaking, across the trajectory of CKD, the literature supports the efficacy of exercise interventions for improving cardiorespiratory fitness and aspects of cardiorenal health. The mechanisms underlying improvements indicate differential effects on traditional and non-traditional risk factors for CKD progression and CVD. To date, there is limited transfer of these findings into clinical care, although the evaluation of available evidence has led to the development of the first detailed clinical practice guideline for exercise and lifestyle in CKD. There is a lack of large-scale multicentre randomized controlled trials, and trials exploring hard clinical outcomes and long-term effects of exercise on cardiorenal outcomes. However, research should also address the challenges of implementing programmes of exercise and PA as part of routine care in combination with addressing the shortfall in literature to improve cardiorenal outcomes in all patients with CKD.
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Billany et al. (2024) studied this question.
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