Advances in Chronic Kidney Disease
Volume 16, Issue 6 , Pages 449-458 , November 2009

Exercise Training and Reduction of Cardiovascular Disease Risk Factors in Patients With Chronic Kidney Disease

  • Ulf G. Bronas

      Affiliations

    • Corresponding Author InformationAddress correspondence to Ulf G. Bronas, PhD, ATC, ATR, University of Minnesota School of Nursing, 5-140 Weaver-Densford Hall; 308 Harvard Street SE, Minneapolis, MN 55455.

References 

  1. Coresh J, Selvin E, Stevens LA, et al. Prevalence of chronic kidney disease in the united states. JAMA. 2007;298:2038–2047
  2. Gilbertson DT, Liu J, Xue JL, et al. Projecting the number of patients with end-stage renal disease in the united states to the year 2015. J Am Soc Nephrol. 2005;16:3736–3741
  3. Clinical Practice Guidelines and Clinical Practice Recommendations for Diabetes and Chronic Kidney Disease. Clinical practice guidelines and clinical practice recommendations for diabetes and chronic kidney disease. Am J Kidney Dis. 2007;49:S2
  4. Foley RN, Parfrey PS, Sarnak MJ. Clinical epidemiology of cardiovascular disease in chronic renal disease. Am J Kidney Dis. 1998;32:S112–S119
  5. Schiffrin EL, Lipman ML, Mann JF. Chronic kidney disease: Effects on the cardiovascular system. Circulation. 2007;116:85–97
  6. Diaz-Buxo JA, Woods HF. Protecting the endothelium: A new focus for management of chronic kidney disease. Hemodial Int. 2006;10:42–48
  7. Culleton BF, Larson MG, Wilson PW, et al. Cardiovascular disease and mortality in a community-based cohort with mild renal insufficiency. Kidney Int. 1999;56:2214–2219
  8. Sarnak MJ, Levey AS, Schoolwerth AC, et al. Kidney disease as a risk factor for development of cardiovascular disease: A statement from the American Heart Association Councils on kidney in cardiovascular disease, high blood pressure research, clinical cardiology, and epidemiology and prevention. Hypertension. 2003;42:1050–1065
  9. Go AS, Chertow GM, Fan D, et al. Chronic kidney disease and the risks of death, cardiovascular events and hospitalization. N Engl J Med. 2004;351:1296–1305
  10. Tonelli M, Wiebe N, Culleton B, et al. Chronic kidney disease and mortality risk: A systematic review. J Am Soc Nephrol. 2006;17:2034–2047
  11. Endemann DH, Schiffrin EL. Endothelial dysfunction. J Am Soc Nephrol. 2004;15:1983–1992
  12. Harrison DG, Cai H. Endothelial control of vasomotion and nitric oxide production. Cardiol Clin. 2003;21:289–302
  13. Himmelfarb J. Relevance of oxidative pathways in the pathophysiology of chronic kidney disease. Cardiol Clin. 2005;23:319–330
  14. Yilmaz MI, Saglam M, Caglar K, et al. The determinants of endothelial dysfunction in CKD: Oxidative stress and asymmetric dimethylarginine. Am J Kidney Dis. 2006;47:42–50
  15. Stam F, van Guldener C, Becker A, et al. Endothelial dysfunction contributes to renal function-associated cardiovascular mortality in a population with mild renal insufficiency: The HOORN study. J Am Soc Nephrol. 2006;17:537–545
  16. Bolton CH, Downs LG, Victory JG, et al. Endothelial dysfunction in chronic renal failure: Roles of lipoprotein oxidation and pro-inflammatory cytokines. Nephrol Dial Transplant. 2001;16:1189–1197
  17. Chade AR, Lerman A, Lerman LO. Kidney in early atherosclerosis. Hypertension. 2005;45:1042-1042
  18. Blacher J, Guerin AP, Pannier B, et al. Impact of aortic stiffness on survival in end-stage renal disease. Circulation. 1999;99:2434–2439
  19. Go AS, Lo JC. Epidemiology of non-dialysis-requiring chronic kidney disease and cardiovascular disease. Curr Opin Nephrol Hypertens. 2006;15:296–302
  20. London G. Pathophysiology of cardiovascular damage in the early renal population. Nephrol Dial Transplant. 2001;16(suppl 2):3–6
  21. The USRDS Dialysis Morbidity and Mortality Study. Wave 2. United States Renal Data System. Am J Kidney Dis. 1997;30:S67–S85
  22. Hutchinson TA, Thomas DC, MacGibbon B. Predicting survival in adults with end-stage renal disease: An age equivalence index. Ann Intern Med. 1982;96:417–423
  23. Miyazato J, Horio T, Takiuchi S, et al. Left ventricular diastolic dysfunction in patients with chronic renal failure: Impact of diabetes mellitus. Diabet Med. 2005;22:730–736
  24. Sietsema KE, Amato A, Adler SG, et al. Exercise capacity as a predictor of survival among ambulatory patients with end-stage renal disease. Kidney Int. 2004;65:719–724
  25. Stack AG, Murthy B. Exercise and limitations in physical activity levels among new dialysis patients in the united states: An epidemiologic study. Ann Epidemiol. 2008;18:880–888
  26. O'Hare AM, Tawney K, Bacchetti P, et al. Decreased survival among sedentary patients undergoing dialysis: Results from the dialysis morbidity and mortality study wave 2. Am J Kidney Dis. 2003;41:447–454
  27. Chen JL, Lerner D, Ruthazer R, et al. Association of physical activity with mortality in chronic kidney disease. J Nephrol. 2008;21:243–252
  28. Nelson ME, Rejeski WJ, Blair SN, et al. Physical activity and public health in older adults: Recommendation from the American College of Sports Medicine and the American Heart Association. Med Sci Sports Exerc. 2007;39:1435–1445
  29. Clark AM, Hartling L, Vandermeer B, et al. Meta-analysis: Secondary prevention programs for patients with coronary artery disease. Ann Intern Med. 2005;143:659–672
  30. Schuler G, Hambrecht R, Schlierf G, et al. Regular physical exercise and low-fat diet. Effects on progression of coronary artery disease. Circulation. 1992;86:1–11
  31. Singh B, Cheema B. Tackling the survival issue in end-stage renal disease: Time to get physical on haemodialysis. Nephrology. 2008;13:560–569
  32. Johansen KL. Exercise in the end-stage renal disease population. J Am Soc Nephrol. 2007;18:145-1854
  33. Johansen KL. Exercise and dialysis. Hemodial Int. 2008;12:209–300
  34. Johansen KL. Exercise and chronic kidney disease: Current recommendations. Sports Med. 2005;35:488–499
  35. Painter PL. Physical functioning in end-stage renal disease patients: Update 2005. Hemodial Int. 2005;9:218–235
  36. Hambrecht R, Adams V, Erbs S, et al. Regular physical activity improves endothelial function in patients with coronary artery disease by increasing phosphorylation of endothelial nitric oxide synthase. Circulation. 2003;107:3152–3158
  37. Edwards DG, Schofield RS, Lennon SL, et al. Effect of exercise training on endothelial function in men with coronary artery disease. Am J Cardiol. 2004;93:617–620
  38. Sandri M, Adams V, Gielen S, et al. Effects of exercise and ischemia on mobilization and functional activation of blood-derived progenitor cells in patients with ischemic syndromes: Results of 3 randomized studies. Circulation. 2005;111:3391–3399
  39. Manfredini F, Rigolin GM, Malagoni AM, et al. Exercise capacity and circulating endothelial progenitor cells in hemodialysis patients. Int J Sports Med. 2007;28:368–373
  40. Tanaka H, Safar ME. Influence of lifestyle modification on arterial stiffness and wave reflections. Am J Hypertens. 2005;18:137–144
  41. Naka KK, Tweddel AC, Parthimos D, et al. Arterial distensibility: Acute changes following dynamic exercise in normal subjects. Am J Physiol Heart Circ Physiol. 2003;284:H970–H978
  42. Mustata S, Chan C, Lai V, et al. Impact of an exercise program on arterial stiffness and insulin resistance in hemodialysis patients. J Am Soc Nephrol. 2004;15:2713–2718
  43. Toussaint ND, Polkinghorne KR, Kerr PG. Impact of intradialytic exercise on arterial compliance and B-type natriuretic peptide levels in hemodialysis patients. Hemodial Int. 2008;12:254–263
  44. Joyner MJ. Effect of exercise on arterial compliance. Circulation. 2000;102:1214–1215
  45. Kasapis C, Thompson PD. The effects of physical activity on serum C-reactive protein and inflammatory markers: A systematic review. J Am Coll Cardiol. 2005;45:1563–1569
  46. Pechter U, Ots M, Mesikepp S, et al. Beneficial effects of water-based exercise in patients with chronic kidney disease. Int J Rehabil Res. 2003;26:153–156
  47. Zaluska A, Zaluska WT, Bednarek-Skublewska A, et al. Nutrition and hydration status improve with exercise training using stationary cycling during hemodialysis (HD) in patients with end-stage renal disease (ESRD). Ann Univ Mariae Curie Sklodowska [Med]. 2002;57:342–346
  48. Kopple JD, Wang H, Casaburi R, et al. Exercise in maintenance hemodialysis patients induces transcriptional changes in genes favoring anabolic muscle. J Am Soc Nephrol. 2007;18:2975–2986
  49. Cheema B, Abas H, Smith B, et al. Progressive exercise for anabolism in kidney disease (PEAK): A randomized, controlled trial of resistance training during hemodialysis. J Am Soc Nephrol. 2007;18:1594–1601
  50. Fagard RH. Exercise characteristics and the blood pressure response to dynamic physical training. Med Sci Sports Exerc. 2001;33:S484–S492
  51. Hagberg JM, Goldberg AP, Ehsani AA, et al. Exercise training improves hypertension in hemodialysis patients. Am J Nephrol. 1983;3:209–212
  52. Painter P, Nelson MM. Effects of exercise training during hemodialysis. Nephron. 1986;43:87–92
  53. Boyce ML, Robergs RA, Avasthi PS, et al. Exercise training by individuals with predialysis renal failure: Cardiorespiratory endurance, hypertension, and renal function. Am J Kidney Dis. 1997;30:180–192
  54. Pechter U, Maaroos J, Mesikepp S, et al. Regular low-intensity aquatic exercise improves cardio-respiratory functional capacity and reduces proteinuria in chronic renal failure patients. Nephrol Dial Transplant. 2003;18:624–625
  55. Clyne N, Ekholm J, Jogestrand T, et al. Effects of exercise training in predialytic uremic patients. Nephron. 1991;59:84–89
  56. Venkataraman R, Sanderson B, Bittner V. Outcomes in patients with chronic kidney disease undergoing cardiac rehabilitation. Am Heart J. 2005;150:1140–1146
  57. Miller BW, Cress CL, Johnson ME, et al. Exercise during hemodialysis decreases the use of antihypertensive medications. Am J Kidney Dis. 2002;39:828–833
  58. Anderson JE, Boivin MR, Hatchett L. Effect of exercise training on interdialytic ambulatory and treatment-related blood pressure in hemodialysis patients. Ren Fail. 2004;26:539–544
  59. Goldberg AP, Hagberg JM, Delmez JA, et al. Metabolic effects of exercise training in hemodialysis patients. Kidney Int. 1980;18:754–761
  60. Goldberg AP, Geltman EM, Hagberg JM, et al. Therapeutic benefits of exercise training for hemodialysis patients. Kidney Int Suppl. 1983;16:S303–S309
  61. Lennon DL, Shrago E, Madden M, et al. Carnitine status, plasma lipid profiles, and exercise capacity of dialysis patients: Effects of a submaximal exercise program. Metabolism. 1986;35:728–735
  62. Durstine JL, Haskell WL. Effects of exercise training on plasma lipids and lipoproteins. Exerc Sport Sci Rev. 1994;22:477–521
  63. Goldberg AP, Hagberg JM, Delmez JA, et al. Exercise training improves abnormal lipid and carbohydrate metabolism in hemodialysis patients. Trans Am Soc Artif Intern Organs. 1979;25:431–437
  64. Kouidi EJ. Central and peripheral adaptations to physical training in patients with end-stage renal disease. Sports Med. 2001;31:651–665
  65. Moore GE, Parsons DB, Stray-Gundersen J, et al. Uremic myopathy limits aerobic capacity in hemodialysis patients. Am J Kidney Dis. 1993;22:277–287
  66. Deligiannis A, Kouidi E, Tassoulas E, et al. Cardiac effects of exercise rehabilitation in hemodialysis patients. Int J Cardiol. 1999;70:253–266
  67. Kouidi E, Albani M, Natsis K, et al. The effects of exercise training on muscle atrophy in hemodialysis patients. Nephrol Dial Transplant. 1998;13:685–699
  68. Deligiannis A, Kouidi E, Tourkantonis A. Effects of physical training on heart rate variability in patients on hemodialysis. Am J Cardiol. 1999;84:197–202
  69. Petraki M, Kouidi E, Grekas D, et al. Effects of exercise training during hemodialysis on cardiac baroreflex sensitivity. Clin Nephrol. 2008;70:210–219
  70. Church TS, Lavie CJ, Milani RV, et al. Improvements in blood rheology after cardiac rehabilitation and exercise training in patients with coronary heart disease. Am Heart J. 2002;143:349–355
  71. Painter PL, Hector L, Ray K, et al. Effects of exercise training on coronary heart disease risk factors in renal transplant recipients. Am J Kidney Dis. 2003;42:362–369

PII: S1548-5595(09)00128-1

doi: 10.1053/j.ackd.2009.07.005

Advances in Chronic Kidney Disease
Volume 16, Issue 6 , Pages 449-458 , November 2009