Trevisani Francesco, Paccagnella Matteo, Angioi Andrea, Fiorio Francesco, Floris Matteo, Pontara Andrea, Rosiello Giuseppe, Violante Silvia, Capitanio Umberto, Salonia Andrea, Montorsi Francesco, Bettiga Arianna
Division of Experimental Oncology, Urological Research Institute (URI), IRCCS San Raffaele Scientific Institute, 20132 Milan, Italy.
Department of Urology, IRCCS San Raffaele Scientific Institute, 20132 Milan, Italy.
Nutrients. 2025 Jan 17;17(2):335. doi: 10.3390/nu17020335.
Physical Activity (PA) provides numerous biological and psychological benefits, especially for cancer patients. PA mitigates treatment side effects, influences hormones, inflammation, adiposity, and immune function, and reduces symptoms of anxiety, depression, and fatigue. This study evaluates the impact of PA on these positive outcomes. An observational retrospective study enrolled 81 patients: 31 with CKD stages II-V and 50 with CKD and urological malignancies. Baseline and 6-month follow-up visits included clinical (Iohexol, Creatinine, Cystatin C) and anthropometric parameters (Bioimpedance Analysis, body circumferences). Physical activity levels were assessed using the Rapid Assessment of Physical Activity (RAPA) test. Patients followed a Mediterranean-like diet with controlled protein intake (MCPD) and received PA improvement advice. Statistical analysis was performed using linear regression and Pearson's Chi-Squared test with R programming. Significant reductions in total adiposity and abdominal fat and improved body fluid distribution were observed. Post intervention, there was a 25.4% reduction in inactive individuals and an 88% increase in active lifestyles. Patients aged 75+ were more likely to be sedentary, indicating a need for increased professional attention. No correlation was found between increased PA and creatinine, cystatin, and eGFR values, but a positive correlation with GFR measured by iohexol clearance remained significant in multivariate analysis. Post intervention, regular PA engagement increased from 12.3% to 48% ( < 0.002). Incorporating PA and nutritional assessments into standard clinical care, supported by a collaborative nephrologist-nutritionist approach, can enhance the quality of life of CKD patients.
体育活动（PA）具有众多生物学和心理学益处，对癌症患者尤为如此。PA可减轻治疗副作用，影响激素、炎症、肥胖和免疫功能，并减轻焦虑、抑郁和疲劳症状。本研究评估了PA对这些积极结果的影响。一项观察性回顾性研究纳入了81名患者：31名处于慢性肾脏病（CKD）II - V期，50名患有CKD和泌尿系统恶性肿瘤。基线和6个月随访包括临床指标（碘海醇、肌酐、胱抑素C）和人体测量参数（生物电阻抗分析、身体周长）。使用体育活动快速评估（RAPA）测试评估体育活动水平。患者遵循蛋白质摄入量受控的类似地中海饮食（MCPD），并接受PA改善建议。使用线性回归和Pearson卡方检验以及R编程进行统计分析。观察到总体肥胖和腹部脂肪显著减少，体液分布得到改善。干预后，不活动个体减少了25.4%，积极生活方式的个体增加了88%。75岁及以上的患者更易久坐不动，这表明需要增加专业关注。未发现PA增加与肌酐、胱抑素和估算肾小球滤过率（eGFR）值之间存在相关性，但在多变量分析中与通过碘海醇清除率测量的肾小球滤过率（GFR）呈正相关仍具有显著性。干预后，定期进行PA的患者比例从12.3%增至48%（P < 0.002）。在肾病专家 - 营养师协作方法的支持下，将PA和营养评估纳入标准临床护理可提高CKD患者的生活质量。
