Nutrition Research Center, Department of Clinical Nutrition, School of Nutrition and Food Sciences, Shiraz University of Medical Sciences, Shiraz 71348-14336, Iran.
Division of Nephrology and Hypertension, Lundquist Institute, Harbor-UCLA Medical Center, Torrance, CA 90502, USA.
Nutrients. 2022 May 20;14(10):2129. doi: 10.3390/nu14102129.
Patients with stages 4 and 5 chronic kidney disease (CKD), and particularly chronic dialysis patients, commonly are found to have substantially reduced daily physical activity in comparison to age- and sex-matched normal adults. This reduction in physical activity is associated with a major decrease in physical exercise capacity and physical performance. The CKD patients are often physically deconditioned, and protein energy wasting (PEW) and frailty are commonly present. These disorders are of major concern because physical dysfunction, muscle atrophy, and reduced muscle strength are associated with poor quality of life and increased morbidity and mortality in CKD and chronic dialysis patients. Many randomized controlled clinical trials indicate that when CKD and chronic dialysis are provided nutritional supplements or undergo exercise training their skeletal muscle mass and exercise capacity often increase. It is not known whether the rise in skeletal muscle mass and exercise capacity associated with nutritional support or exercise training will reduce morbidity or mortality rates. A limitation of these clinical trials is that the sample sizes of the different treatment groups were small. The aim of this review is to discuss the effects of nutrition and exercise on body composition, exercise capacity, and physical functioning in advanced CKD patients.
患有 4 期和 5 期慢性肾脏病（CKD）的患者，特别是慢性透析患者，与年龄和性别匹配的正常成年人相比，通常被发现日常体力活动明显减少。体力活动的减少与体力活动能力和身体表现的显著下降有关。CKD 患者通常身体状况不佳，常伴有蛋白质能量消耗（PEW）和虚弱。这些疾病令人担忧，因为身体功能障碍、肌肉萎缩和肌肉力量下降与 CKD 和慢性透析患者的生活质量差、发病率和死亡率增加有关。许多随机对照临床试验表明，当 CKD 和慢性透析患者接受营养补充或进行运动训练时，其骨骼肌质量和运动能力通常会增加。目前尚不清楚与营养支持或运动训练相关的骨骼肌质量和运动能力的增加是否会降低发病率或死亡率。这些临床试验的一个局限性是，不同治疗组的样本量较小。本综述的目的是讨论营养和运动对晚期 CKD 患者身体成分、运动能力和身体功能的影响。
