Leicester Kidney Lifestyle Team, Department of Health Sciences, University of Leicester, Leicester, UK.
Department of Surgery, Johns Hopkins University School of Medicine.
Curr Opin Nephrol Hypertens. 2020 Sep;29(5):471-479. doi: 10.1097/MNH.0000000000000627.
Chronic kidney disease (CKD) is characterized by poor levels of physical activity which contribute to increased morbidity across the disease trajectory. The short nature, small samples, and poor methodology across most studies have failed to translate the role of exercise in CKD into its adoption as a frontline adjunct therapeutic option. This review focuses on recent advances surrounding the benefits of exercise interventions across the CKD spectrum.
Key recent advances in exercise studies have focused on the efficacy of novel intervention strategies across the CKD spectrum. These include high-intensity interval training, virtual reality gaming, intradialytic yoga, electrical stimulation of muscles, blood flow restriction training, and protocols combining exercise with nutritional supplementation. Research is also beginning to explore the role of prehabilitation for patients prior to dialysis and kidney transplantation.
Studies continue to demonstrate wide-ranging benefits of exercise across CKD; however, implementation of exercise remains scarce. Future research needs include evaluating the efficacy of larger and/or more comprehensive interventions on clinically important outcomes. It is hoped with increasing global evidence, high-quality clinical studies, and sustained clinician and patient engagement, exercise programs will become better prioritized in the nephrology field.
慢性肾脏病（CKD）的特点是身体活动水平较差，这会导致疾病进程中的发病率增加。大多数研究的研究周期短、样本量小且方法学较差，这使得运动在 CKD 中的作用无法转化为将其作为一线辅助治疗选择。本综述重点介绍了围绕 CKD 谱中运动干预的益处的最新进展。
运动研究中的最新进展主要集中在 CKD 谱中新型干预策略的疗效上。这些策略包括高强度间歇训练、虚拟现实游戏、透析内瑜伽、肌肉电刺激、血流限制训练以及将运动与营养补充相结合的方案。研究也开始探索预康复在透析和肾移植前患者中的作用。
研究继续证明了 CKD 患者运动的广泛益处；然而，运动的实施仍然很少。未来的研究需求包括评估更大和/或更全面的干预措施对临床重要结局的疗效。人们希望随着全球证据的增加、高质量的临床研究以及临床医生和患者的持续参与，运动方案将在肾病学领域得到更好的优先考虑。
