Objectives: Chronic kidney disease (CKD) is prevalent, affecting 13% of adult Australians and poses
increased risk for cardiovascular morbidity and mortality. This position article provides evidence-based
guidelines on the role of exercise training for CKD patients and provides recommendations for prescribing
and delivering exercise training.
Design: Position stand.
Methods: Synthesis of published work within the field of exercise training and chronic kidney disease.
Results: Exercise training likely to provide benefits to CKD patients, including improvements in cardiorespiratory
fitness, quality of life, sympatho-adrenal activity, muscle strength and increased energy intake
and possible reduction in inflammatory biomarkers. Existing studies generally report small sample sizes,
brief training periods and relatively high attrition rates. Exercise training appears to be safe for CKD
patients with no deaths directly related to exercise training in over 30,000 patient-hours, although strict
medical exclusion criteria in previous studies resulted in 25% of patients being excluded potentially
impacting the generalisability of the findings.
Conclusions: Aerobic exercise at an intensity of >60% of maximum capacity is recommended to improve
cardio-respiratory fitness. Few data are available on resistance training and it is unclear whether this form
of training retards catabolic/inflammatory processes typical of CKD. However, it should be considered
important due to its proven beneficial effects on bone density andmusclemass. Due to the high prevalence
and incidence of co-morbidities in CKD patients, exercise training programs should be prescribed and
delivered by individuals with appropriate qualifications and experience to recognise and accommodate
co-morbidities and associated complications
Objectives: Chronic kidney disease (CKD) is prevalent, affecting 13% of adult Australians and posesincreased risk for cardiovascular morbidity and mortality. This position article provides evidence-basedguidelines on the role of exercise training for CKD patients and provides recommendations for prescribingand delivering exercise training.Design: Position stand.Methods: Synthesis of published work within the field of exercise training and chronic kidney disease.Results: Exercise training likely to provide benefits to CKD patients, including improvements in cardiorespiratoryfitness, quality of life, sympatho-adrenal activity, muscle strength and increased energy intakeand possible reduction in inflammatory biomarkers. Existing studies generally report small sample sizes,brief training periods and relatively high attrition rates. Exercise training appears to be safe for CKDpatients with no deaths directly related to exercise training in over 30,000 patient-hours, although strictmedical exclusion criteria in previous studies resulted in 25% of patients being excluded potentiallyimpacting the generalisability of the findings.Conclusions: Aerobic exercise at an intensity of >60% of maximum capacity is recommended to improvecardio-respiratory fitness. Few data are available on resistance training and it is unclear whether this formof training retards catabolic/inflammatory processes typical of CKD. However, it should be consideredimportant due to its proven beneficial effects on bone density andmusclemass. Due to the high prevalenceand incidence of co-morbidities in CKD patients, exercise training programs should be prescribed anddelivered by individuals with appropriate qualifications and experience to recognise and accommodateco-morbidities and associated complications
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