Van Craenenbroeck Amaryllis H, Van Craenenbroeck Emeline M, Kouidi Evangelia, Vrints Christiaan J, Couttenye Marie M, Conraads Viviane M
Departments of Nephrology and Laboratory for Molecular and Cellular Cardiology, University of Antwerp, Edegem, Belgium; and
Laboratory for Molecular and Cellular Cardiology, University of Antwerp, Edegem, Belgium; and Cardiology, Antwerp University Hospital, Edegem, Belgium;
Clin J Am Soc Nephrol. 2014 Jul;9(7):1305-18. doi: 10.2215/CJN.13031213. Epub 2014 May 15.
Cardiovascular disease remains the main cause of morbidity and mortality in patients with CKD, an observation that cannot be explained by the coexistence of traditional risk factors alone. Recently, other mechanisms, such as alterations in nitric oxide bioavailability, impaired endothelial repair mechanisms, inflammation, and oxidative stress (all characteristic in CKD), have gained much attention as mediators for the increased cardiovascular risk. Regular physical training is a valuable nonpharmacological intervention for primary and secondary prevention of cardiovascular disease. Likewise, the benefits of exercise training on exercise capacity and quality of life are increasingly recognized in patients with CKD. Furthermore, exercise training could also influence potential reversible mechanisms involved in atherosclerosis and arteriosclerosis. After discussing briefly the general concepts of vascular disease in CKD, this review provides an overview of the current evidence for the effects of exercise training at both clinical and preclinical levels. It concludes with some practical considerations on exercise training in this specific patient group.
心血管疾病仍然是慢性肾脏病患者发病和死亡的主要原因，这一现象无法仅用传统危险因素的共存来解释。最近，其他机制，如一氧化氮生物利用度改变、内皮修复机制受损、炎症和氧化应激（这些都是慢性肾脏病的特征），作为心血管风险增加的介导因素受到了广泛关注。规律的体育锻炼是心血管疾病一级和二级预防的一项有价值的非药物干预措施。同样，运动训练对慢性肾脏病患者运动能力和生活质量的益处也越来越得到认可。此外，运动训练还可能影响动脉粥样硬化和动脉硬化中潜在的可逆机制。在简要讨论了慢性肾脏病中血管疾病的一般概念后，本综述概述了目前临床和临床前水平上运动训练效果的证据。最后对这一特定患者群体的运动训练提出了一些实际考虑。
