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Erschienen in: International Urology and Nephrology 4/2011

01.12.2011 | Nephrology – Original Paper

Effects of exercise training on physical impairment, arterial stiffness and health-related quality of life in patients with chronic kidney disease: a pilot study

verfasst von: Stefan Mustata, Sharon Groeneveld, Warren Davidson, Gordon Ford, Kristal Kiland, Braden Manns

Erschienen in: International Urology and Nephrology | Ausgabe 4/2011

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Abstract

Background

Patients with chronic kidney disease (CKD) have impaired performance in physical tasks, lower health-related quality of life and high cardiovascular morbidity and mortality. Moderate intensity exercise has been shown to provide cardiovascular and metabolic benefits in healthy individuals and patients without CKD. Long-term exercise training is recommended as a vital component in the management of a number of chronic diseases. This randomized controlled pilot project examined the effects of exercise in predialysis CKD patients.

Methods

Ten patients were randomized to 12 months of exercise (EX) and 10 to standard care (CT). We compared the difference between the two groups in physical impairment (VO2peak and endurance time [ET]), arterial stiffness (augmentation index [AI]) and health-related quality of life (EuroQol EQ-5D and Short Form-36 questionnaires) (all measured at baseline and 12 months).

Results

The difference between EX and CT was statistically significant for VO2peak (3.59 ml O2/kg/min; 95% CI 0.92, 6.26; P = 0.01), ET (10.97 min; 95% CI 4.34, 17.59; P = 0.003) and AI (−11.7%; 95% CI −18.79, −4.61; P = 0.003). Clinically important changes were noted in EQ-5D and SF-36.

Conclusions

This study suggests that long-term exercise training improves physical impairment, arterial stiffness and health-related quality of life in patients with predialysis CKD. A larger randomized trial is required to examine the impact of exercise on markers of cardiovascular risk and quality of life in predialysis CKD patients.
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Literatur
1.
Zurück zum Zitat Levin A, Hemmelgarn B, Culleton B et al (2008) Guidelines for the management of chronic kidney disease. Can Med Assoc J 179:1154–1162CrossRef Levin A, Hemmelgarn B, Culleton B et al (2008) Guidelines for the management of chronic kidney disease. Can Med Assoc J 179:1154–1162CrossRef
2.
Zurück zum Zitat Johansen KL, Chertow GM, Ng AV et al (2000) Physical activity levels in patients on hemodialysis and healthy sedentary controls. Kidney Int 57:2564–2570PubMedCrossRef Johansen KL, Chertow GM, Ng AV et al (2000) Physical activity levels in patients on hemodialysis and healthy sedentary controls. Kidney Int 57:2564–2570PubMedCrossRef
3.
Zurück zum Zitat Padilla J, Krasnoff J, DaSilva M et al (2008) Physical functioning in patients with chronic kidney disease. J Nephrol 21:550–559PubMed Padilla J, Krasnoff J, DaSilva M et al (2008) Physical functioning in patients with chronic kidney disease. J Nephrol 21:550–559PubMed
4.
Zurück zum Zitat Blair SN, Kohl HW, Paffenbarger RS, Clark DG, Cooper KH, Gibbons LW (1989) Physical fitness and all-cause mortality: a prospective study of healthy men and women. JAMA 262:2395–2401PubMedCrossRef Blair SN, Kohl HW, Paffenbarger RS, Clark DG, Cooper KH, Gibbons LW (1989) Physical fitness and all-cause mortality: a prospective study of healthy men and women. JAMA 262:2395–2401PubMedCrossRef
5.
Zurück zum Zitat Myers J, Prakash M, Froelicher V, Do D, Partington S, Atwood JE (2002) Exercise capacity and mortality among men referred for exercise testing. N Engl J Med 346:793–801PubMedCrossRef Myers J, Prakash M, Froelicher V, Do D, Partington S, Atwood JE (2002) Exercise capacity and mortality among men referred for exercise testing. N Engl J Med 346:793–801PubMedCrossRef
6.
Zurück zum Zitat Green DJ, O’Driscoll G, Joyner MJ, Cable NT (2008) Exercise and cardiovascular risk reduction: time to update the rationale for exercise? J Appl Physiol 105:766–768PubMedCrossRef Green DJ, O’Driscoll G, Joyner MJ, Cable NT (2008) Exercise and cardiovascular risk reduction: time to update the rationale for exercise? J Appl Physiol 105:766–768PubMedCrossRef
7.
Zurück zum Zitat O’Hare AM, Tawney K, Bacchetti P, Johansen KL (2003) Decreased survival among sedentary patients undergoing dialysis: results from the dialysis morbidity and mortality study wave 2. Am J Kidney Dis 41:447–454PubMedCrossRef O’Hare AM, Tawney K, Bacchetti P, Johansen KL (2003) Decreased survival among sedentary patients undergoing dialysis: results from the dialysis morbidity and mortality study wave 2. Am J Kidney Dis 41:447–454PubMedCrossRef
8.
Zurück zum Zitat Culleton BF, Hemmelgarn BR (2003) Is chronic kidney disease a cardiovascular disease risk factor? Semin Dial 16:95–100PubMedCrossRef Culleton BF, Hemmelgarn BR (2003) Is chronic kidney disease a cardiovascular disease risk factor? Semin Dial 16:95–100PubMedCrossRef
9.
Zurück zum Zitat Keith DS, Nichols GA, Guillion CM, Brown JB, Smith DH (2004) Longitudinal follow-up and outcomes among a population with chronic kidney disease in a large managed care organization. Arch Intern Med 164:659–663PubMedCrossRef Keith DS, Nichols GA, Guillion CM, Brown JB, Smith DH (2004) Longitudinal follow-up and outcomes among a population with chronic kidney disease in a large managed care organization. Arch Intern Med 164:659–663PubMedCrossRef
10.
Zurück zum Zitat Group Diabetes Prevention Program Research (2002) Reduction in the incidence of type 2 diabetes with lifestyle intervention or metformin. N Engl J Med 346:393–403CrossRef Group Diabetes Prevention Program Research (2002) Reduction in the incidence of type 2 diabetes with lifestyle intervention or metformin. N Engl J Med 346:393–403CrossRef
11.
Zurück zum Zitat McGavock JM, Eves ND, Mandic S, Glenn NM, Quinney HA, Haykowsky MJ (2004) The role of exercise in the treatment of cardiovascular disease associated with type 2 diabetes mellitus. Sports Med 34:27–48PubMedCrossRef McGavock JM, Eves ND, Mandic S, Glenn NM, Quinney HA, Haykowsky MJ (2004) The role of exercise in the treatment of cardiovascular disease associated with type 2 diabetes mellitus. Sports Med 34:27–48PubMedCrossRef
12.
Zurück zum Zitat Sigal RJ, Kenny GP, Boule NG et al (2007) Effects of aerobic training, resistance training, or both on glycemic control in type 2 diabetes: a randomized trial. Ann Intern Med 147:357–369PubMed Sigal RJ, Kenny GP, Boule NG et al (2007) Effects of aerobic training, resistance training, or both on glycemic control in type 2 diabetes: a randomized trial. Ann Intern Med 147:357–369PubMed
13.
Zurück zum Zitat Taylor RS, Brown A, Ebrahim S et al (2004) Exercise-based rehabilitation for patients with coronary heart disease: systematic review and meta-analysis of randomized controlled trials. Am J Med 116:682–692PubMedCrossRef Taylor RS, Brown A, Ebrahim S et al (2004) Exercise-based rehabilitation for patients with coronary heart disease: systematic review and meta-analysis of randomized controlled trials. Am J Med 116:682–692PubMedCrossRef
14.
Zurück zum Zitat Smart N, Marwick TH (2004) Exercise training for patients with heart failure: a systematic review of factors that improve mortality and morbidity. Am J Med 116:693–706PubMedCrossRef Smart N, Marwick TH (2004) Exercise training for patients with heart failure: a systematic review of factors that improve mortality and morbidity. Am J Med 116:693–706PubMedCrossRef
15.
Zurück zum Zitat Ries AL, Bauldoff GS, Carlin BW et al (2007) Pulmonary rehabilitation: joint ACCP/AACVPR evidence-based clinical practice guidelines. Chest 131:4S–42SPubMedCrossRef Ries AL, Bauldoff GS, Carlin BW et al (2007) Pulmonary rehabilitation: joint ACCP/AACVPR evidence-based clinical practice guidelines. Chest 131:4S–42SPubMedCrossRef
16.
Zurück zum Zitat Koufaki P, Mercer TH, Naish PF (2002) Effects of exercise training on aerobic and functional capacity of end-stage renal disease patients. Clin Physiol Funct Imaging 22:115–124PubMedCrossRef Koufaki P, Mercer TH, Naish PF (2002) Effects of exercise training on aerobic and functional capacity of end-stage renal disease patients. Clin Physiol Funct Imaging 22:115–124PubMedCrossRef
18.
Zurück zum Zitat Painter P (2005) Physical functioning in end-stage renal disease patients: update 2005. Hemodial Int 9:218–235PubMedCrossRef Painter P (2005) Physical functioning in end-stage renal disease patients: update 2005. Hemodial Int 9:218–235PubMedCrossRef
19.
Zurück zum Zitat Thompson PD, Buchner D, Pina IL et al (2003) Exercise and physical activity in the prevention and treatment of atherosclerotic cardiovascular disease. Circulation 107:3109–3116PubMedCrossRef Thompson PD, Buchner D, Pina IL et al (2003) Exercise and physical activity in the prevention and treatment of atherosclerotic cardiovascular disease. Circulation 107:3109–3116PubMedCrossRef
20.
Zurück zum Zitat Petrella R, Lattanzio CN, Demeray A, Varallo V, Blore R (2005) Can adoption of regular exercise later in life prevent metabolic risk for cardiovascular disease? Diabetes Care 28:694–701PubMedCrossRef Petrella R, Lattanzio CN, Demeray A, Varallo V, Blore R (2005) Can adoption of regular exercise later in life prevent metabolic risk for cardiovascular disease? Diabetes Care 28:694–701PubMedCrossRef
21.
Zurück zum Zitat Booth FW, Gordon SE, Carlson CJ, Hamilton MT (2000) Waging war on modern chronic diseases: primary prevention through exercise biology. J Appl Physiol 88:774–787PubMed Booth FW, Gordon SE, Carlson CJ, Hamilton MT (2000) Waging war on modern chronic diseases: primary prevention through exercise biology. J Appl Physiol 88:774–787PubMed
22.
Zurück zum Zitat Dickinson HO, Mason JM, Nicolson DJ et al (2006) Lifestyle interventions to reduce raised blood pressure: a systematic review of randomized controlled trials. J Hypertens 24:215–233PubMedCrossRef Dickinson HO, Mason JM, Nicolson DJ et al (2006) Lifestyle interventions to reduce raised blood pressure: a systematic review of randomized controlled trials. J Hypertens 24:215–233PubMedCrossRef
23.
Zurück zum Zitat Stewart KJ (2002) Exercise training and the cardiovascular consequences of type 2 diabetes and hypertension: plausible mechanisms for improving cardiovascular health. JAMA 288:1622–1631PubMedCrossRef Stewart KJ (2002) Exercise training and the cardiovascular consequences of type 2 diabetes and hypertension: plausible mechanisms for improving cardiovascular health. JAMA 288:1622–1631PubMedCrossRef
24.
Zurück zum Zitat Durstine JL, Grandjean PW, Davis PG, Ferguson MA, Alderson NL, DuBose KD (2001) Blood lipid and lipoprotein adaptations to exercise: a quantitative analysis. Sports Med 31:1033–1062PubMedCrossRef Durstine JL, Grandjean PW, Davis PG, Ferguson MA, Alderson NL, DuBose KD (2001) Blood lipid and lipoprotein adaptations to exercise: a quantitative analysis. Sports Med 31:1033–1062PubMedCrossRef
25.
Zurück zum Zitat Hardman AE (1999) Interaction of physical activity and diet: implications for lipoprotein metabolism. Public Health Nutr 2:369–376PubMedCrossRef Hardman AE (1999) Interaction of physical activity and diet: implications for lipoprotein metabolism. Public Health Nutr 2:369–376PubMedCrossRef
26.
Zurück zum Zitat Sato Y, Nagasaki M, Nakai N, Fushimi T (2003) Physical exercise improves glucose metabolism in lifestyle-related diseases. Exp Biol Med (Maywood) 228:1208–1212 Sato Y, Nagasaki M, Nakai N, Fushimi T (2003) Physical exercise improves glucose metabolism in lifestyle-related diseases. Exp Biol Med (Maywood) 228:1208–1212
27.
Zurück zum Zitat Houmard JA, Tanner CJ, Slentz CA, Duscha BD, McCartney JS, Kraus WE (2004) Effect of the volume and intensity of exercise training on insulin sensitivity. J Appl Physiol 96:101–106PubMedCrossRef Houmard JA, Tanner CJ, Slentz CA, Duscha BD, McCartney JS, Kraus WE (2004) Effect of the volume and intensity of exercise training on insulin sensitivity. J Appl Physiol 96:101–106PubMedCrossRef
28.
Zurück zum Zitat Vaitkevicius PV, Fleg JL, Engel JH et al (1993) Effects of age and aerobic capacity on arterial stiffness in healthy adults. Circulation 88:1456–1462PubMed Vaitkevicius PV, Fleg JL, Engel JH et al (1993) Effects of age and aerobic capacity on arterial stiffness in healthy adults. Circulation 88:1456–1462PubMed
29.
Zurück zum Zitat Mustata S, Chan C, Lai V, Miller JA (2004) Impact of an exercise program on arterial stiffness and insulin resistance in hemodialysis patients. J Am Soc Nephrol 15:2713–2718PubMedCrossRef Mustata S, Chan C, Lai V, Miller JA (2004) Impact of an exercise program on arterial stiffness and insulin resistance in hemodialysis patients. J Am Soc Nephrol 15:2713–2718PubMedCrossRef
30.
Zurück zum Zitat Briet M, Bozec E, Laurent S et al (2006) Arterial stiffness and enlargement in mild-to-moderate chronic kidney disease. Kidney Int 69:350–357PubMedCrossRef Briet M, Bozec E, Laurent S et al (2006) Arterial stiffness and enlargement in mild-to-moderate chronic kidney disease. Kidney Int 69:350–357PubMedCrossRef
31.
Zurück zum Zitat Blacher J, Guerin AP, Pannier B, Marchais SJ, Safar ME, London GM (1999) Impact of aortic stiffness on survival in end-stage renal disease. Circulation 99:2434–2439PubMed Blacher J, Guerin AP, Pannier B, Marchais SJ, Safar ME, London GM (1999) Impact of aortic stiffness on survival in end-stage renal disease. Circulation 99:2434–2439PubMed
32.
Zurück zum Zitat London GM, Blacher J, Pannier B, Guerin AP, Marchais SJ, Safar ME (2001) Arterial wave reflections and survival in end-stage renal failure. Hypertension 38:434–438PubMed London GM, Blacher J, Pannier B, Guerin AP, Marchais SJ, Safar ME (2001) Arterial wave reflections and survival in end-stage renal failure. Hypertension 38:434–438PubMed
33.
Zurück zum Zitat National Kidney Foundation (2005) K/DOQI Clinical practice guidelines for cardiovascular disease in dialysis patients. Am J Kidney Dis 45(Suppl 3):S1–S153 National Kidney Foundation (2005) K/DOQI Clinical practice guidelines for cardiovascular disease in dialysis patients. Am J Kidney Dis 45(Suppl 3):S1–S153
34.
Zurück zum Zitat Borg GA (1982) Psychophysical bases of perceived exertion. Med Sci Sports Exerc 14:377–381PubMed Borg GA (1982) Psychophysical bases of perceived exertion. Med Sci Sports Exerc 14:377–381PubMed
35.
Zurück zum Zitat Chen CH, Nevo E, Fetics B et al (1997) Estimation of central aortic pressure waveform by mathematical transformation of radial tonometry pressure. Validation of generalized transfer function. Circulation 95:1827–1836 Chen CH, Nevo E, Fetics B et al (1997) Estimation of central aortic pressure waveform by mathematical transformation of radial tonometry pressure. Validation of generalized transfer function. Circulation 95:1827–1836
36.
Zurück zum Zitat Canadian Agency for Drugs and Technologies in Health (2006) Guidelines for the economic evaluation of health technologies: Canada, 3rd edn. Ottawa Canadian Agency for Drugs and Technologies in Health (2006) Guidelines for the economic evaluation of health technologies: Canada, 3rd edn. Ottawa
37.
Zurück zum Zitat Manns B, Johnson JA, Taub K, Mortis G, Ghali WA, Donaldson C (2003) Quality of life in patients treated with hemodialysis or peritoneal dialysis: what are the important determinants? Clin Nephrol 60:341–351PubMed Manns B, Johnson JA, Taub K, Mortis G, Ghali WA, Donaldson C (2003) Quality of life in patients treated with hemodialysis or peritoneal dialysis: what are the important determinants? Clin Nephrol 60:341–351PubMed
38.
Zurück zum Zitat Wight JP, Edwards L, Brazier J, Walters S, Payne JN, Brown CB (1998) The SF36 as an outcome measure of services for end stage renal failure. Qual Health Care 7:209–221PubMedCrossRef Wight JP, Edwards L, Brazier J, Walters S, Payne JN, Brown CB (1998) The SF36 as an outcome measure of services for end stage renal failure. Qual Health Care 7:209–221PubMedCrossRef
39.
40.
Zurück zum Zitat Liem YS, Bosch JL, Hunink MG (2008) Preference-based quality of life of patients on renal replacement therapy: a systematic review and meta-analysis. Value Health 11:733–741PubMedCrossRef Liem YS, Bosch JL, Hunink MG (2008) Preference-based quality of life of patients on renal replacement therapy: a systematic review and meta-analysis. Value Health 11:733–741PubMedCrossRef
41.
Zurück zum Zitat Boyce ML, Robergs RA, Avasthi PS et al (1997) Exercise training by individuals with predialysis renal failure: cardiorespiratory endurance, hypertension, and renal function. Am J Kidney Dis 30:180–192PubMedCrossRef Boyce ML, Robergs RA, Avasthi PS et al (1997) Exercise training by individuals with predialysis renal failure: cardiorespiratory endurance, hypertension, and renal function. Am J Kidney Dis 30:180–192PubMedCrossRef
42.
Zurück zum Zitat Sietsema KE, Amato A, Adler SG, Brass EP (2004) Exercise capacity as a predictor of survival among ambulatory patients with end-stage renal disease. Kidney Int 65:712–724CrossRef Sietsema KE, Amato A, Adler SG, Brass EP (2004) Exercise capacity as a predictor of survival among ambulatory patients with end-stage renal disease. Kidney Int 65:712–724CrossRef
43.
Zurück zum Zitat Cheema BS, Fiatarone Singh MA (2005) Exercise training in patients receiving maintenance hemodialysis: a systematic review of clinical trials. Am J Nephr 25:352–364CrossRef Cheema BS, Fiatarone Singh MA (2005) Exercise training in patients receiving maintenance hemodialysis: a systematic review of clinical trials. Am J Nephr 25:352–364CrossRef
44.
Zurück zum Zitat Kodama S, Saito K, Tanaka S et al (2009) Cardiorespiratory fitness as a quantitative predictor of all-cause mortality and cardiovascular events in healthy men and women: a meta-analysis. JAMA 301:2024–2035PubMedCrossRef Kodama S, Saito K, Tanaka S et al (2009) Cardiorespiratory fitness as a quantitative predictor of all-cause mortality and cardiovascular events in healthy men and women: a meta-analysis. JAMA 301:2024–2035PubMedCrossRef
45.
Zurück zum Zitat Covic A, Gusbeth-Tatomir P, Goldsmith D (2005) Arterial stiffness in renal patients: an update. Am J Kidney Dis 45:965–977PubMedCrossRef Covic A, Gusbeth-Tatomir P, Goldsmith D (2005) Arterial stiffness in renal patients: an update. Am J Kidney Dis 45:965–977PubMedCrossRef
46.
Zurück zum Zitat Hoeymans N, van Lindert H, Westert GP (2005) The health status of the Dutch population as assessed by EQ-6D. Qual Life Res 14:655–663PubMedCrossRef Hoeymans N, van Lindert H, Westert GP (2005) The health status of the Dutch population as assessed by EQ-6D. Qual Life Res 14:655–663PubMedCrossRef
47.
Zurück zum Zitat Painter P, Carlson L, Carey S, Paul SM, Myll J (2000) Physical functioning and health related quality of life changes with exercise training in hemodialysis patients. Am J Kidney Dis 35:482–492PubMedCrossRef Painter P, Carlson L, Carey S, Paul SM, Myll J (2000) Physical functioning and health related quality of life changes with exercise training in hemodialysis patients. Am J Kidney Dis 35:482–492PubMedCrossRef
48.
Zurück zum Zitat Painter P, Carlson L, Carey S, Paul SM, Myll J (2000) Low-functioning hemodialysis patients improve with exercise training. Am J Kidney Dis 36:600–608PubMedCrossRef Painter P, Carlson L, Carey S, Paul SM, Myll J (2000) Low-functioning hemodialysis patients improve with exercise training. Am J Kidney Dis 36:600–608PubMedCrossRef
49.
Zurück zum Zitat Haskell W, Lee I, Pate R et al (2007) Physical activity and public health: updated recommendations for adults from the American College of Sports Medicine and the American Heart Association. Circulation 116:1081–1093PubMedCrossRef Haskell W, Lee I, Pate R et al (2007) Physical activity and public health: updated recommendations for adults from the American College of Sports Medicine and the American Heart Association. Circulation 116:1081–1093PubMedCrossRef
50.
Zurück zum Zitat Nelson M, Rejeski WJ, Blair S et al (2007) Physical activity and public health in older adults: recommendation from the American College of Sports Medicine and the American Heart Association. Circulation 116:1094–1105PubMedCrossRef Nelson M, Rejeski WJ, Blair S et al (2007) Physical activity and public health in older adults: recommendation from the American College of Sports Medicine and the American Heart Association. Circulation 116:1094–1105PubMedCrossRef
51.
Zurück zum Zitat Nonoyama ML, Brooks D, Ponikvar A et al. (2010) Exercise program to enhance physical performance and quality of life of older hemodialysis patients: a feasibility study. Int Urol Nephrol Mar 7 [Epub ahead of print] Nonoyama ML, Brooks D, Ponikvar A et al. (2010) Exercise program to enhance physical performance and quality of life of older hemodialysis patients: a feasibility study. Int Urol Nephrol Mar 7 [Epub ahead of print]
52.
Zurück zum Zitat Segura-Orti E, Kouidi E, Lison JF (2009) Effect of resistance exercise during hemodialysis on physical function and quality of life: randomized controlled trial. Clinic Nephrol 71:527–537 Segura-Orti E, Kouidi E, Lison JF (2009) Effect of resistance exercise during hemodialysis on physical function and quality of life: randomized controlled trial. Clinic Nephrol 71:527–537
53.
Zurück zum Zitat Sakkas GK, Hadjigeorgiou GM, Karatzaferi C et al (2008) Intradialytic aerobic exercise training ameliorates symptoms of restless legs syndrome and improves functional capacity in patients on hemodialysis: a pilot study. ASAIO J 54:185–190PubMedCrossRef Sakkas GK, Hadjigeorgiou GM, Karatzaferi C et al (2008) Intradialytic aerobic exercise training ameliorates symptoms of restless legs syndrome and improves functional capacity in patients on hemodialysis: a pilot study. ASAIO J 54:185–190PubMedCrossRef
Metadaten
Titel
Effects of exercise training on physical impairment, arterial stiffness and health-related quality of life in patients with chronic kidney disease: a pilot study
verfasst von
Stefan Mustata
Sharon Groeneveld
Warren Davidson
Gordon Ford
Kristal Kiland
Braden Manns
Publikationsdatum
01.12.2011
Verlag
Springer Netherlands
Erschienen in
International Urology and Nephrology / Ausgabe 4/2011
Print ISSN: 0301-1623
Elektronische ISSN: 1573-2584
DOI
https://doi.org/10.1007/s11255-010-9823-7

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