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Journal of Nephrology

Open Access 13-09-2024 | Chronic Kidney Disease | Position papers and Guidelines

Physical activity and exercise in chronic kidney disease: consensus statements from the Physical Exercise Working Group of the Italian Society of Nephrology

Authors: Yuri Battaglia, Federica Baciga, Francesca Bulighin, Maria Amicone, Giovanni Mosconi, Alda Storari, Rachele Brugnano, Marco Pozzato, Daria Motta, Claudia D’alessandro, Claudia Torino, Francesca Mallamaci, Adamasco Cupisti, Filippo Aucella, Alessandro Capitanini, Working Group of Physical Exercise of Italian Society of Nephrology

Published in: Journal of Nephrology

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Abstract

The Italian Society of Nephrology has tasked its Working Group on Physical Exercise with developing a consensus statement document on physical activity and exercise in patients with chronic kidney disease (CKD). This paper consists of 16 points that were discussed, and approved using the mini-Delphi method by 15 members of the working group. Each statement is based on a comprehensive review of the literature, clinical experience, and expert opinions. Overall, the statements affirm that regular physical activity and exercise training offer numerous benefits to CKD patients, including improved physical function, enhanced cardiometabolic and neuromuscular function, cognitive benefits, and an overall improvement in quality of life. Furthermore, exercise may provide nephroprotection and reduce mortality. These advantages are observed across all CKD stages, whether on conservative therapy or kidney replacement therapy (hemodialysis or peritoneal dialysis), and in kidney transplant recipients. Moreover, when physical activity and exercise training are implemented with appropriate precautions, they are safe in CKD patients. Gradual physical activity and customized exercise programs should be tailored to the patient's exercise tolerance, potentially enhancing compliance. Clinicians are encouraged to use a series of questionnaires and tests to assess the patient's level of physical activity and performance. However, exercise and physical activity are poorly implemented in clinical practice due to many barriers related to patients and healthcare staff. Overcoming these barriers requires the proactive role of the nephrologists, who should actively incorporate exercise training and promote physical activity within routine care plans. Adopting a multidisciplinary team approach, which includes nephrologists, nurses, exercise professionals, and dietitians, is crucial for providing comprehensive rehabilitation for CKD patients. Integrating new technologies and remote check ups could further enhance the effectiveness of these interventions.

Graphical abstract

Literature
1.
K/DOQI Workgroup (2005) K/DOQI clinical practice guidelines for cardiovascular disease in dialysis patients. Am J Kidney Dis 45(4 Supple 3):S1-153
2.
Stevens PE, Levin A, Improving Global Outcomes Chronic Kidney Disease Guideline Development Work Group Members (2013) Evaluation and management of chronic kidney disease: synopsis of the kidney disease: improving global outcomes 2012 clinical practice guideline. Ann Intern Med 158(11):825–830PubMedCrossRef
3.
Mallamaci F, Pisano A, Tripepi G (2020) Physical activity in chronic kidney disease and the EXerCise introduction to enhance trial. Nephrol Dial Transplant 35(Suppl 2):ii18–ii22PubMedPubMedCentralCrossRef
4.
5.
Deligiannis A, D’Alessandro C, Cupisti A (2021) Exercise training in dialysis patients: impact on cardiovascular and skeletal muscle health. Clin Kidney J 14(2):25–33CrossRef
6.
Hansen D, Niebauer J, Cornelissen V, Barna O, Neunhäuserer D, Stettler C, Tonoli C, Greco E, Fagard R, Coninx K, Vanhees L, Piepoli MF, Pedretti R, Ruiz GR, Corrà U, Schmid JP, Davos CH, Edelmann F, Abreu A, Rauch B, Ambrosetti M, Braga SS, Beckers P, Bussotti M, Faggiano P, Garcia-Porrero E, Kouidi E, Lamotte M, Reibis R, Spruit MA, Takken T, Vigorito C, Völler H, Doherty P, Dendale P (2018) Exercise prescription in patients with different combinations of cardiovascular disease risk factors: a consensus statement from the EXPERT working group. Sports Med 48(8):1781–1797PubMedCrossRef
7.
Bull FC, Al-Ansari SS, Biddle S, Borodulin K, Buman MP, Cardon G, Carty C, Chaput JP, Chastin S, Chou R, Dempsey PC, DiPietro L, Ekelund U, Firth J, Friedenreich CM, Garcia L, Gichu M, Jago R, Katzmarzyk PT, Lambert E, Leitzmann M, Milton K, Ortega FB, Ranasinghe C, Stamatakis E, Tiedemann A, Troiano RP, van der Ploeg HP, Wari V, Willumsen JF (2020) World health organization 2020 guidelines on physical activity and sedentary behaviour. Br J Sports Med 54(24):1451–1462PubMedCrossRef
8.
Baker LA, March DS, Wilkinson TJ, Billany RE, Bishop NC, Castle EM, Chilcot J, Davies MD, Graham-Brown MPM, Greenwood SA, Junglee NA, Kanavaki AM, Lightfoot CJ, Macdonald JH, Rossetti GMK, Smith AC, Burton JO (2022) Clinical practice guideline exercise and lifestyle in chronic kidney disease. BMC Nephrol 23(1):75PubMedPubMedCentralCrossRef
9.
Kidney Disease: Improving Global Outcomes (KDIGO) CKD Work Group (2024) KDIGO 2024 clinical practice guideline for the evaluation and management of chronic kidney disease. Kidney Int 105(4):S117–S314CrossRef
10.
Lambert K, Lightfoot CJ, Jegatheesan DK, Gabrys I, Bennett PN (2022) Physical activity and exercise recommendations for people receiving dialysis: a scoping review. PLoS ONE 17(4):e0267290PubMedPubMedCentralCrossRef
11.
12.
13.
14.
15.
16.
Seidu S, Abdool M, Almaqhawi A, Wilkinson TJ, Kunutsor SK, Khunti K, Yates T (2023) Physical activity and risk of chronic kidney disease: systematic review and meta-analysis of 12 cohort studies involving 1,281,727 participants. Eur J Epidemiol 38(3):267–280PubMedPubMedCentralCrossRef
17.
Wilkinson TJ, Clarke AL, Nixon DGD, Hull KL, Song Y, Burton JO, Yates T, Smith AC (2021) Prevalence and correlates of physical activity across kidney disease stages: an observational multicentre study. Nephrol Dial Transplant 36(4):641–649PubMedCrossRef
18.
19.
Bellos I et al (2023) Association of physical activity with endothelial dysfunction among adults with and without chronic kidney disease: the maastricht study. Atherosclerosis 383:117330PubMedCrossRef
20.
Elia R, Piva G, Bulighin F, Lamberti N, Manfredini F, Gambaro G, Di Maria A, Salvagno G, Carbonare LGD, Storari A, Valenti MT, Battaglia Y, Working Group of Physical Exercise of Italian Society of Nephrology (2024) The impact of physical exercise on microRNAs in hemodialysis patients: a review and a protocol for an ancillary study. Biomedicines. 12(2):468PubMedPubMedCentralCrossRef
21.
Battaglia Y, Lamberti N, Piva G, Manfredini F, Storari A (2021) Physical exercise in chronic kidney disease: an empty narrative or an effective intervention? G Ital Nefrol 38(6):2021-vol6PubMed
22.
Torino C, Manfredini F, Bolignano D, Aucella F, Baggetta R, Barillà A, Battaglia Y, Bertoli S, Bonanno G, Castellino P, Ciurlino D, Cupisti A, D’Arrigo G, De Paola L, Fabrizi F, Fatuzzo P, Fuiano G, Lombardi L, Lucisano G, Messa P, Rapanà R, Rapisarda F, Rastelli S, Rocca-Rey L, Summaria C, Zuccalà A, Tripepi G, Catizone L, Zoccali C, Mallamaci F, EXCITE Working Group (2014) Physical performance and clinical outcomes in dialysis patients: a secondary analysis of the EXCITE trial. Kidney Blood Press Res 39(2–3):205–11PubMedCrossRef
23.
Baggetta R, Bolignano D, Torino C, Manfredini F, Aucella F, Barillà A, Battaglia Y, Bertoli S, Bonanno G, Castellino P, Ciurlino D, Cupisti A, D’Arrigo G, De Paola L, Fabrizi F, Fatuzzo P, Fuiano G, Lombardi L, Lucisano G, Messa P, Rapanà R, Rapisarda F, Rastelli S, Rocca-Rey L, Summaria C, Zuccalà A, Abd ElHafeez S, Tripepi G, Catizone L, Mallamaci F, Zoccali C, EXCITE Working Group (2014) Fitness for entering a simple exercise program and mortality: a study corollary to the exercise introduction to enhance performance in dialysis (EXCITE) trial. Kidney Blood Press Res 39(2–3):197–204PubMedCrossRef
24.
25.
26.
27.
28.
29.
Pu J, Jiang Z, Wu W, Li L, Zhang L, Li Y, Liu Q, Ou S (2019) Efficacy and safety of intradialytic exercise in haemodialysis patients: a systematic review and meta-analysis. BMJ Open 9(1):e020633PubMedPubMedCentralCrossRef
30.
Lin CH, Hsu YJ, Hsu PH, Lee YL, Lin CH, Lee MS, Chiang SL (2021) Effects of intradialytic exercise on dialytic parameters, health-related quality of life, and depression status in hemodialysis patients: a randomized controlled trial. Int J Environ Res Public Health 18(17):9205PubMedPubMedCentralCrossRef
31.
Baggetta R, D’Arrigo G, Torino C, ElHafeez SA, Manfredini F, Mallamaci F, Zoccali C, Tripepi G, EXCITE Working group (2018) Effect of a home-based, low-intensity, physical exercise program in older adults dialysis patients: a secondary analysis of the EXCITE trial. BMC Geriatr 18(1):248PubMedPubMedCentralCrossRef
32.
Isnard-Rouchon M, West M, Bennett PN (2019) Exercise and physical activity for people receiving peritoneal dialysis: why not? Semin Dial 32(4):303–307PubMedCrossRef
33.
Howden EJ, Coombes JS, Strand H, Douglas B, Campbell KL, Isbel NM (2015) Exercise training in CKD: efficacy, adherence, and safety. Am J Kidney Dis 65(4):583–591PubMedCrossRef
34.
Calella P, Hernández-Sánchez S, Garofalo C, Ruiz JR, Carrero JJ, Bellizzi V (2019) Exercise training in kidney transplant recipients: a systematic review. J Nephrol 32(4):567–579PubMedCrossRef
35.
Roi GS, Mosconi G, Totti V, Angelini ML, Brugin E, Sarto P, Merlo L, Sgarzi S, Stancari M, Todeschini P, La Manna G, Ermolao A, Tripi F, Andreoli L, Sella G, Anedda A, Stefani L, Galanti G, Di Michele R, Merni F, Trerotola M, Storani D, Nanni CA (2018) Renal function and physical fitness after 12-mo supervised training in kidney transplant recipients. World J Transplant 8(1):13–22PubMedPubMedCentralCrossRef
36.
Clarke AL, Zaccardi F, Gould DW et al (2019) Association of self-reported physical function with survival in patients with chronic kidney disease. Clin Kidney J 12:122–128PubMedCrossRef
37.
Kurella Tamura M, Covinsky KE, Chertow GM et al (2009) Functional status of elderly adults before and after initiation of dialysis. N Engl J Med 361:1539–1547PubMedCrossRef
38.
Fuentes-Abolafio IJ, Escriche-Escuder A, Bernal-López MR, Gómez-Huelgas R, Ricci M, Trinidad-Fernández M, Roldán-Jiménez C, Arjona-Caballero JM, Cuesta-Vargas AI, Pérez-Belmonte LM (2022) Estimation of functional aerobic capacity using the sit-to-stand test in older adults with heart failure with preserved ejection fraction. J Clin Med 11(10):2692PubMedPubMedCentralCrossRef
39.
Manfredini F, Mallamaci F, Arrigo GR, Bolignano D, Torino C, Lamberti N, Bertoli S, Ciurlino D, Rocca-Rey L, Barillà A, Battaglia Y, Rapanà RM, Zuccalà A, Bonanno G, Fatuzzo P, Rapisarda F, Rastelli S, Fabrizi F, Messa P, De Paola L, Lombardi L, Cupisti A, Fuiano G, Lucisano G, Summaria C, Felisatti M, Pozzato E, Malagoni AM, Castellino P, Aucella F, Abd ElHafeez S, Provenzano PF, Tripepi G, Catizone L, Zoccali C (2017) Exercise in patients on dialysis: a multicenter, randomized clinical trial. J Am Soc Nephrol 28(4):1259–1268PubMedCrossRef
40.
Walker SR, Brar R, Eng F et al (2015) Frailty and physical function in chronic kidney disease: the CanFIT study. Can J Kidney Heal Dis 2:1–10
41.
Iman Y, Harasemiw O, Tangri N (2020) Assessing physical function in chronic kidney disease. Curr Opin Nephrol Hypertens 29(3):346–350PubMedCrossRef
42.
Brodin E, Ljungman S, Sunnerhagen KS (2008) Rising from a chair: a simple screening test for physical function in predialysis patients. Scand J Urol Nephrol 42:293–300PubMedCrossRef
43.
MacRae JM, Harasemiw O, Lightfoot CJ, Thompson S, Wytsma-Fisher K, Koufaki P, Bohm C, Wilkinson TJ (2023) Measurement properties of performance-based measures to assess physical function in chronic kidney disease: recommendations from a COSMIN systematic review. Clin Kidney J 16(11):2108–2128PubMedPubMedCentralCrossRef
44.
Nogueira Á, Álvarez G, Russo F, San-José B, Sánchez-Tomero JA, Barril G (2019) Is SPPB useful as a screening method of functional capacity in patients with advanced chronic kidney disease? Nefrologia (Engl Ed) 39(5):489–496 (English, Spanish)PubMedCrossRef
45.
Zanotto T, Gobbo S, Bullo V et al (2020) Postural balance, muscle strength, and history of falls in end-stage renal disease patients living with a kidney transplant: a cross-sectional study. Gait Posture 76:358–363PubMedCrossRef
46.
Ortega-Perez de Villar L, Martınez-Olmos FJ, Junque-Jimenez A et al (2018) Test- & retest reliability and minimal detectable change scores for the short physical performance battery, one-legged standing test and timed up and go test in patients undergoing hemodialysis. PLoS ONE 2018(13):1–16 (Validation study of the SPPB and other physical function tests in chronic kidney disease, demonstrating excellent test–retest reliability)
47.
Wilkinson TJ, Nixon DG, Smith AC (2019) Postural stability during standing and its association with physical and cognitive functions in nondialysis chronic kidney disease patients. Int Urol Nephrol 51:1407–1414PubMedPubMedCentralCrossRef
48.
Guralnik JM, Ferrucci L, Pieper CF, Leveille SG, Markides KS, Ostir GV, Studenski S, Berkman LF, Wallace RB (2000) Lower extremity function and subsequent disability: consistency across studies, predictive models, and value of gait speed alone compared with the short physical performance battery. J Gerontol Ser A Boil Sci Med Sci 55:221–231
49.
Fulinara CP, Huynh A, Goldwater D, Abdalla B, Schaenman J (2023) Frailty and age-associated assessments associated with chronic kidney disease and transplantation outcomes. J Transplant 1(2023):1510259
50.
Mosconi G, Angelini ML, Balzi W, Totti V, Roi GS, Cappuccilli M, Tonioli M, Storani D, Trerotola M, Costa AN (2016) Can solid-organ-transplanted patients perform a cycling marathon? Trends in kidney function parameters in comparison with healthy subjects. Transplant Proc 48(2):415–419PubMedCrossRef
51.
Reese PP, Cappola AR, Shults J et al (2013) Physical performance and frailty in chronic kidney disease. Am J Nephrol 38(4):307–315PubMedCrossRef
52.
53.
54.
Verberne WR, Das-Gupta Z, Allegretti AS et al (2019) Developed of an international standard set of value-based outcome measures for patients with chronic kidney disease: a report of the international consortium for health outcomes measurement (ICHOM) CKD working group. Am J Kidney Dis 73:372–384PubMedCrossRef
55.
Aiyegbusi OL, Kyte D, Cockwell P et al (2017) Measurement properties of patient- reported outcome measures (PROMs) used in adult patients with chronic kidney disease: a systematic review. PLoS ONE 12:e0179733PubMedPubMedCentralCrossRef
56.
Peipert JD, Nair D, Klicko K et al (2019) Kidney Disease Quality of Life 36-Item & Short Form survey (KDQOL-36) normative values for the United States dialysis population and new single summary score. J Am Soc Nephrol 30:654–663PubMedPubMedCentralCrossRef
57.
Katz S, Ford AB, Moskowitz RW et al (1963) Studies of Illness in the aged. The index of ADL: a standardised measure of biological and psychosocial function. JAMA 185:914–919PubMedCrossRef
58.
Lawton MP, Brody EM (1969) Assessment of older people: self-maintaining and instrumental activities of daily living. Gerontologist 9:179–186PubMedCrossRef
59.
Bergner M, Bobbitt RA, Carter WB et al (1981) The sickness impact profile: development and final revision of a health status measure. Med Care 19:787–805PubMedCrossRef
60.
61.
Keating XD, Zhou K, Liu X, Hodges M, Liu J, Guan J, Phelps A, Castro-Piñero J (2019) Reliability and concurrent validity of global physical activity questionnaire (GPAQ): a systematic review. Int J Environ Res Public Health 16(21):4128PubMedPubMedCentralCrossRef
62.
Wilkinson TJ, Palmer J, Gore EF, Smith AC (2022) The validity of the “General practice physical activity questionnaire” against accelerometery in patients with chronic kidney disease. Physiother Theory Pract 38(10):1528–1537PubMedCrossRef
63.
Ball TJ, Joy EA, Gren LH, Shaw JM (2016) Concurrent validity of a self-reported physical activity “vital sign” questionnaire with adult primary care patients. Prev Chronic Dis 4(13):E16
64.
Davidson M, de Morton N (2007) A systematic review of the human activity profile. Clin Rehab 21:151–162CrossRef
65.
Johansen KL, Painter P, Kent-Braun JA, Ng AV, Carey S, Da Silva M, Chertow GM (2001) Validation of questionnaires to estimate physical activity and functioning in end-stage renal disease. Kidney Int 59(3):1121–1127PubMedCrossRef
66.
Robinson-Cohen C, Littman AJ, Duncan GE, Roshanravan B, Ikizler TA, Himmelfarb J, Kestenbaum BR (2013) Assessment of physical activity in chronic kidney disease. J Ren Nutr 23(2):123–131PubMedCrossRef
67.
Zhang L, Luo H, Kang G, Wang W, Hu Y (2017) The association between physical activity and mortality among patients undergoing maintenance hemodialysis. Int J Nurs Pract 23:e12505CrossRef
68.
Filipčič T, Bogataj Š, Pajek J, Pajek M (1978) Physical activity and quality of life in hemodialysis patients and healthy controls: a cross-sectional study. Int J Environ Res Public Health 2021:18
69.
Hayhurst WS, Ahmed A (2015) Assessment of physical activity in patients with chronic kidney disease and renal replacement therapy. Springerplus 4(1):536 (Erratum in: Springerplus. 2016;5(1):961)PubMedPubMedCentralCrossRef
70.
van Hees VT, Slootmaker SM, De Groot G, Van Mechelen W, van Lummel RC (2009) Reproducibility of a triaxial seismic accelerometer (DynaPort). Med Sci Sports Exerc 41:810–817PubMedCrossRef
71.
Bakker EA, Zoccali C, Dekker FW, Eijsvogels TMH, Jager KJ (2020) Assessing physical activity and function in patients with chronic kidney disease: a narrative review. Clin Kidney J 14(3):768–779PubMedPubMedCentralCrossRef
72.
Castaneda C, Gordon PL, Uhlin KL, Levey AS, Kehayias JJ, Dwyer JT, Fielding RA, Roubenoff R, Singh MF (2001) Resistance training to counteract the catabolism of a low-protein diet in patients with chronic renal insufficiency. A randomised, controlled trial. Ann Intern Med 135(11):965–76PubMedCrossRef
73.
Balakrishnan VS, Rao M, Menon V, Gordon PL, Pilichowska M, Castaneda F, Castaneda-Sceppa C (2010) Resistance training increases muscle mitochondrial biogenesis in patients with chronic kidney disease. Clin J Am Soc Nephrol 5(6):996–1002PubMedPubMedCentralCrossRef
74.
Garibotto G, Picciotto D, Saio M, Esposito P (2020) Verzola D muscle protein turnover and low-protein diets in patients with chronic kidney disease. Nephrol Dial Transplant 35(5):741–751PubMedCrossRef
75.
van Vliet S, Skinner SK, Beals JW et al (2018) Dysregulated handling of dietary and muscle protein synthesis after mixed meal ingestion in maintenance hemodialysis patients. Kidney Int Rep 3:1403–1415PubMedPubMedCentralCrossRef
76.
Dong J, Sundell MB, Pupim LB et al (2011) The effect of resistance exercise to augment long-term benefits of intradialytic oral nutritional supplementation in chronic hemodialysis patients. J Ren Nutr 21:149–159PubMedCrossRef
77.
Majchrzak KM, Pupim LB, Flakoll PJ et al (2007) Resistance exercise augments the acute anabolic effects of intradialytic oral nutritional supplementation. Nephrol Dial Transplant 23:1362–1369PubMedCrossRef
78.
Farnfield MM, Breen L, Carey KA et al (2012) Activation of mTOR signalling in young and old human skeletal muscle in response to combined resistance exercise and whey protein ingestion. Appl Physiol Nutr Metab 37:21–30PubMedCrossRef
79.
Kakigi R, Yoshihara T, Ozaki H et al (2014) Whey protein intake after resistance exercise activates mTOR signaling in a dose dependent manner in human skeletal muscle. Eur J Appl Physiol 114:735–742PubMedCrossRef
80.
Hendriks FK, Kuijpers JHW, van Kranenburg JMX, Senden JMG, van der Sande FM, Kooman JP, Meex SJR, van Loon LJC (2023) Intradialytic protein ingestion and exercise do not compromise uremic toxin removal throughout hemodialysis. J Ren Nutr 33(2):376–385PubMedCrossRef
81.
Kutner NG (2010) Rehabilitation in the renal population: barriers to access. Seminar Nephrol 30:59–65CrossRef
82.
83.
Delgado C, Johansen KL (2012) Barriers to exercise participation among dialysis patients. Nephrol Dial Transpl 27:1152–7CrossRef
84.
Fiaccadori E, Sabatino A, Schito F, Angella F, Malagoli M, Tucci M et al (2014) Barriers to physical activity in chronic hemodialysis patients: a single-center pilot study in an Italian dialysis facility. Kidney Blood Press Res 39:169–75PubMedCrossRef
85.
Regolisti G, Maggiore U, Sabatino A, Gandolfini I, Pioli S, Torino C, Aucella F, Cupisti A, Pistolesi V, Capitanini A, Caloro G, Gregorini M, Battaglia Y, Mandreoli M, Dani L, Mosconi G, Bellizzi V, Di Iorio BR, Conti P, Fiaccadori E (2018) Interaction of healthcare staff’s attitude with barriers to physical activity in hemodialysis patients: a quantitative assessment. PLoS ONE 13(4):e0196313. https://​doi.​org/​10.​1371/​journal.​pone.​0196313. (Erratum in: PLoS One. 2018 Jun 20;13(6):e0198987)CrossRefPubMedPubMedCentral
86.
Jhamb M, McNulty ML, Ingalsbe G, Childers JW, Schell J, Conroy MB et al (2016) Knowledge, barriers and facilitators of exercise in dialysis patients: a qualitative study of patients, staff and nephrologists. BMC Nephrol 17:192PubMedPubMedCentralCrossRef
87.
88.
Ferrari F, Andrade FP, Teixeira MS et al (2023) Efficacy of six exercise-based interventions for individuals undergoing hemodialysis: a network meta-analysis of randomised clinical trials. Nephrol Dial Transplant 38:2389–406PubMedCrossRef
89.
Taryana AA, Krishnasamy R, Bohm C, Palmer SC, Wiebe N, Boudville N, MacRae J, Coombes JS, Hawley C, Isbel N, Thompson S (2019) Physical activity for people with chronic kidney disease: an international survey of nephrologist practice patterns and research priorities. BMJ Open 9(12):e032322PubMedPubMedCentralCrossRef
90.
Johansen KL, Sakkas GK, Doyle J, Tiffany Shubert R, Dudley A (2003) Exercise counseling practices among nephrologists caring for patients on dialysis. Am J Kidney Dis 41(1):171–178PubMedCrossRef
91.
Roshanravan B, Gamboa J, Wilund K (2017) Exercise and CKD: skeletal muscle dysfunction and practical application of exercise to prevent and treat physical impairments in CKD. Am J Kidney Dis 69(6):837–852PubMedPubMedCentralCrossRef
92.
Luan X, Tian X, Zhang H, Huang R, Li N, Chen P, Wang R (2019) Exercise as a prescription for patients with various diseases. J Sport Health Sci 8(5):422–441PubMedPubMedCentralCrossRef
93.
Shiozaki K, Asaeda M, Hashimoto T, Umemoto Y, Ito H, Takahashi T, Nishimura Y, Tajima F (2023) Effects of physiatrist and physiotherapist-supervised therapeutic exercise on physical function in frail older patients with multimorbidity. Prog Rehabil Med 4(8):20230012
94.
Sheng K, Zhang P, Chen L, Cheng J, Wu C, Chen J (2014) Intradialytic exercise in hemodialysis patients: a systematic review and meta-analysis. Am J Nephrol 40(5):478–490PubMedCrossRef
95.
Manfredini F, Lamberti N, Battaglia Y, Straudi S, Belvederi Murri M, Donadi M, Piva G, Fabbian F, López-Soto PJ, Grassi L, Manfredini R, Basaglia N, Storari A (2020) A personalized patient-centered intervention to empower through physical activity the patient in the dialysis center: study protocol for a pragmatic nonrandomized clinical trial. Methods Protoc 3(4):83PubMedPubMedCentralCrossRef
96.
Zoccali C, Manfredini F, Kanbay M, Mallamaci F (2023) Intradialysis exercise in haemodialysis patients: effective but complex and costly. Nephrol Dial Transplant 39(1):7–9PubMedCrossRef
97.
Torkington M, MacRae M, Isles C (2006) Uptake of and adherence to exercise during hospital haemodialysis. Physiotherapy 92(2):83–87CrossRef
98.
Perez-Dominguez B, Casaña-Granell J, Garcia-Maset R, Garcia-Testal A, Melendez-Oliva E, Segura-Orti E (2021) Effects of exercise programs on physical function and activity levels in patients undergoing hemodialysis: a randomised controlled trial. Eur J Phys Rehabil Med 57(6):994–1001PubMedCrossRef
99.
Battaglia Y, Amicone M, Mantovani A, Combe C, Mitra S, Basile C (2023) Home-based exercise in patients on maintenance dialysis: a systematic review and meta-analysis of randomised clinical trials. Nephrol Dial Trans 38:2550–61CrossRef
100.
Cho JH, Lee JY, Lee S, Park H, Choi SW, Kim JC (2018) Effect of intradialytic exercise on daily physical activity and sleep quality in maintenance hemodialysis patients. Int Urol Nephrol 50(4):745–754PubMedCrossRef
101.
Anding-Rost K, von Gersdorff G, von Korn P, Ihorst G, Josef A, Kaufmann M, Huber M, Bär T, Zeißler S, Höfling S, Breuer C, Gärtner N, Haykowsky MJ, Degenhardt S, Wanner C, Halle M (2023) Exercise during hemodialysis in patients with chronic kidney failure. NEJM Evid. 2(9):2300057CrossRef
102.
Manfredini F, D’arrigo G, Lamberti N, Torino C, Tripepi G, Mallamaci F, Zoccali C (2022) The legacy effect of a home walking exercise programme in kidney failure patients on dialysis. Nephrol Dial Trans 37(10):1974–1981CrossRef
103.
Pei G, Tang Y, Tan L, Tan J, Ge L, Qin W (2019) Aerobic exercise in adults with chronic kidney disease (CKD): a meta-analysis. Int Urol Nephrol 51(10):1787–1795PubMedCrossRef
104.
Abdelbasset WK, Ibrahim AA, Althomali OW, Hussein HM, Alrawaili SM, Alsubaie SF (2022) Effect of twelve-week concurrent aerobic and resisted exercise training in non-dialysis day on functional capacity and quality of life in chronic kidney disease patients. Eur Rev Med Pharmacol Sci 26(17):6098–6106PubMed
105.
Bernier-Jean A, Beruni NA, Bondonno NP, Williams G, Teixeira-Pinto A, Craig JC, Wong G (2022) Exercise training for adults undergoing maintenance dialysis. Cochrane Database Syst Rev 1(1):14653
106.
Huang M, Lv A, Wang J, Xu N, Ma G, Zhai Z, Zhang B, Gao J, Ni C (2019) Exercise training and outcomes in hemodialysis patients: systematic review and meta-analysis. Am J Nephrol 50(4):240–254PubMedCrossRef
107.
Stack AG, Molony DA, Rives T, Tyson J, Murthy BV (2005) Association of physical activity with mortality in the US dialysis population. Am J Kidney Dis 45(4):690–701PubMedCrossRef
108.
Watson EL, Gould DW, Wilkinson TJ, Xenophontos S, Clarke AL, Vogt BP, Viana JL, Smith AC (2018) Twelve-week combined resistance and aerobic training confers greater benefits than aerobic training alone in non-dialysis CKD. Am J Physiol Renal Physiol 314(6):F1188–F1196PubMedCrossRef
109.
Ainsworth BE, Haskell WL, Whitt MC, Irwin ML, Swartz AM, Strath SJ, O’Brien WL, Bassett DR Jr, Schmitz KH, Emplaincourt PO, Jacobs DR Jr, Leon AS (2000) Compendium of physical activities: an update of activity codes and MET intensities. Med Sci Sports Exerc 32(9 Suppl):S498-504PubMedCrossRef
110.
111.
Peng W, Han M, Xu G (2023) Gender differences in the association between physical activity and mortality in chronic kidney disease: results from the national health and nutrition examination survey (2011–2018). J Clin Med 12(3):779PubMedPubMedCentralCrossRef
112.
113.
Morishita S, Tsubaki A, Takabayashi T, Fu JB (2018) Relationship between the rating of perceived exertion scale and the load intensity of resistance training. Strength Cond J 40(2):94–109PubMedPubMedCentralCrossRef
114.
Borg GA (1982) Psychophysical bases of perceived exertion. Med Sci Sports Exerc 14(5):377–381 (PMID: 7154893)PubMedCrossRef
115.
KD Workgroup (2005) DOQI clinical practice guidelines for cardiovascular disease in dialysis patients. Am J Kidney, Dis 45:16–153CrossRef
116.
117.
Roi GS, Stefoni S, Mosconi G, Brugin E, Burra P, Ermolao A, Granito M, Macini P, Mastrosimone S, Nacchia F, Pegoraro C, Rigotti P, Sella G, Sgarzi S, Tamè MR, Totti V, Trerotola M, Tripi F, Nanni CA (2014) Physical activity in solid organ transplant recipients: organisational aspects and preliminary results of the Italian project. Transplant Proc 46(7):2345–2349PubMedCrossRef
118.
Ribeiro HS, Andrade FP, Leal DV, Oliveira JS, Wilund KR, Viana JL (2023) How is exercise being prescribed for patients on hemodialysis? A scoping review J Nephrol 36(5):1307–1319PubMed
119.
Aucella F, Gesuete A, Battaglia Y (2014) A “nephrological” approach to physical activity. Kidney Blood Press Res 39(2–3):189–196PubMedCrossRef
120.
Bulighin F, Aucella F, Bellizzi V, Cupisti A, Faga T, Gambaro G, Regolisti G, Storari A, Capitanini A, Battaglia Y; Working Group of Physical Exercise of Italian Society of Nephrology. 2024 Physical activity and exercise programs for kidney patients: an Italian survey of nephrology centres. J Nephrol
121.
Martínez-Majolero V, Urosa B, Hernández-Sánchez S (2022) Physical exercise in people with chronic kidney disease-practices and perception of the knowledge of health professionals and physical activity and sport science professionals about their prescription. Int J Environ Res Public Health 19(2):656PubMedPubMedCentralCrossRef
122.
Bennett PN, Bohm C, Yee-Moon Wang A, Kanjanabuch T, Figueiredo AE, Harasemiw O, Brown L, Gabrys I, Jegatheesan D, Lambert K, Lightfoot CJ, MacRae J, Scholes-Robertson N, Stewart K, Tarca B, Verdin N, Warren M, West M, Zimmerman D, Finderup J, Ford E, Ribeiro HS, Xu Q, Thompson S (2023) An international survey of peritoneal dialysis exercise practices and perceptions. Kidney Int Rep 8(7):1389–1398PubMedPubMedCentralCrossRef
123.
Yamagata K, Hoshino J, Sugiyama H et al (2019) Clinical practice guideline for renal rehabilitation: systematic reviews and recommendations of exercise therapies in patients with kidney diseases. Ren Replace Ther 5:28CrossRef
124.
Morgan AM, King AC, Viana J, Wilund KR (2022) Exercise in dialysis: ready for prime time? Blood Purif 25:1–5
125.
Wilkinson TJ, McAdams-DeMarco M, Bennett PN, Wilund K (2020) Advances in exercise therapy in predialysis chronic kidney disease, hemodialysis, peritoneal dialysis, and kidney transplantation. Curr Opin Nephrol Hypertens 29(5):471–479PubMedPubMedCentralCrossRef
126.
Greenwood SA, Young HML, Briggs J, Castle EM, Walklin C, Haggis L, Balkin C, Asgari E, Bhandari S, Burton JO, Billany RE, Bishop NC, Bramham K, Campbell J, Chilcot J, Cooper NJ, Deelchand V, Graham-Brown MPM, Hamilton A, Jesky M, Kalra PA, Koufaki P, McCafferty K, Nixon AC, Noble H, Saynor Z, Taal MW, Tollit J, Wheeler DC, Wilkinson TJ, Worboys H, Macdonald JH (2024) Evaluating the effect of a digital health intervention to enhance physical activity in people with chronic kidney disease (Kidney BEAM): a multicentre, randomised controlled trial in the UK. Lancet Digit Health 6(1):e23–e32PubMedCrossRef
127.
Li WY, Chiu FC, Zeng JK, Li YW, Huang SH, Yeh HC, Cheng BW, Yang FJ (2020) Mobile health app with social media to support self-management for patients with chronic kidney disease: prospective randomized controlled study. J Med Internet Res 22(12):e19452PubMedPubMedCentralCrossRef
128.
Gurz D, Coimbatore Dada K, Naga Nyshita V, Aderibigbe FD, Singh M, Yadav KP, Shah SK, Pumbhadia B, Abbas K, Khan W, Kumaran V (2023) The impact of virtual reality (VR) gaming and casual/social gaming on the quality of life, depression, and dialysis tolerance in patients with chronic kidney disease: a narrative review. Cureus 15(9):e44904PubMedPubMedCentral
129.
Segura-Ortí E, Pérez-Domínguez B, Ortega-Pérez de Villar L, Meléndez-Oliva E, Martínez-Gramage J, García-Maset R, Gil-Gómez JA (2019) Virtual reality exercise intradialysis to improve physical function: a feasibility randomised trial. Scand J Med Sci Sports 29(1):89–94PubMedCrossRef
130.
Maynard LG, de Menezes DL, Lião NS, de Jesus EM, Andrade NLS, Santos JCD, da Silva Júnior WM, Bastos KA, Barreto Filho JAS (2019) Effects of exercise training combined with virtual reality in functionality and health-related quality of life of patients on hemodialysis. Games Health J 8(5):339–348PubMedCrossRef
131.
Herron A, Cavanaugh KL, Umeukeje EM, Ikizler TA, Birdee G (2022) A pilot randomized trial of intradialysis yoga for patients with end-stage kidney disease. Kidney Int Rep 8(2):357–359PubMedPubMedCentralCrossRef
Metadata
Title
Physical activity and exercise in chronic kidney disease: consensus statements from the Physical Exercise Working Group of the Italian Society of Nephrology
Authors
Yuri Battaglia
Federica Baciga
Francesca Bulighin
Maria Amicone
Giovanni Mosconi
Alda Storari
Rachele Brugnano
Marco Pozzato
Daria Motta
Claudia D’alessandro
Claudia Torino
Francesca Mallamaci
Adamasco Cupisti
Filippo Aucella
Alessandro Capitanini
Working Group of Physical Exercise of Italian Society of Nephrology
Publication date
13-09-2024
Publisher
Springer International Publishing
Published in
Journal of Nephrology
Print ISSN: 1121-8428
Electronic ISSN: 1724-6059
DOI
https://doi.org/10.1007/s40620-024-02049-9

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