Master Sankar Raj Vimal, Patel Dilip R, Ramachandran Lakshmi
Children's Hospital of Illinois, University of Illinois College of Medicine at Peoria, Peoria, IL, USA.
Western Michigan University Homer Stryker MD School of Medicine, Kalamazoo, MI 49008, USA.
Transl Pediatr. 2017 Jul;6(3):207-214. doi: 10.21037/tp.2017.06.03.
Individuals suffering from chronic kidney disease (CKD) deal with major morbidity and mortality including poor exercise tolerance. A variety of factors including anemia, poor muscle mass, cardiovascular changes and limited physical activity contribute to exercise intolerance. Studies suggest that early initiation of aerobic and resistance training improves the muscle function, ability to tolerate exercise and quality of life in CKD patients. A thorough medical examination and exercise testing are recommended before initiating an exercise regimen in individuals with CKD. Though current recommendations suggest a qualified approval to contact sports in patients with solitary kidney, a proper risk assessment and counselling must be provided detailing all the risks involved. Special care must be taken to avoid infection or damage to the peritoneal dialysis catheter and hemodialysis vascular access sites. Collision sports should be avoided in individuals with kidney transplant, ectopic kidney or with other urological abnormalities (severe hydronephrosis or ureteropelvic junction obstruction) with high risk of injury.
患有慢性肾脏病（CKD）的个体面临着包括运动耐量差在内的主要发病和死亡风险。多种因素，包括贫血、肌肉量少、心血管变化和身体活动受限，导致运动不耐受。研究表明，早期开始有氧运动和抗阻训练可改善CKD患者的肌肉功能、运动耐受能力和生活质量。建议在为CKD患者制定运动方案之前进行全面的医学检查和运动测试。尽管目前的建议表明对单肾患者参与接触性运动给予有条件的批准，但必须进行适当的风险评估并提供咨询，详细说明所有涉及的风险。必须特别注意避免感染或损伤腹膜透析导管和血液透析血管通路部位。肾移植患者、异位肾患者或有其他泌尿系统异常（严重肾积水或肾盂输尿管连接部梗阻）且受伤风险高的个体应避免进行碰撞性运动。
