Vandecruys Marieke, Schockaert Gillian, Coemans Maarten, Denhaerynck Kris, Deberdt Géraldine, Cornelissen Véronique, Van Craenenbroeck Amaryllis H, De Smet Stefan
Nephrology and Renal Transplantation Research Group, Department of Microbiology, Immunology and Transplantation, KU Leuven, Leuven, Belgium.
Exercise Physiology Research Group, Department of Movement Sciences, KU Leuven, Leuven, Belgium.
BMJ Open Sport Exerc Med. 2025 Aug 6;11(3):e002481. doi: 10.1136/bmjsem-2025-002481. eCollection 2025.
This viewpoint aims to characterise the evolution of peak oxygen uptake (V̇Opeak) in chronic kidney disease (CKD), describe its impact on patients' ability to engage in physical activities of daily living and frame the meaningfulness of exercise training in this respect. Analysis of literature data from 4889 patients shows that per cent-predicted V̇Opeak decreases from 69%±10% at CKD stage 2 to 51%±9% at CKD stage 5, before partially recovering to 60%±12% beyond 12 months post-transplant. Similarly, V̇Opeak expressed as oxygen uptake relative to body weight decreases from 24.7±4.1 to 18.0±3.4 mL/kg/min across CKD stage 2-5, with a partial recovery to 21.6±4.9 mL/kg/min beyond 12 months post-transplant. Considerable variability exists in reported V̇Opeak levels at each of the different disease stages. In a substantial proportion of patients, impaired cardiorespiratory fitness contributes to limitations in performing common physical activities such as brisk walking, carrying groceries upstairs, mowing the lawn or engaging in vigorous play with (grand-)children. Tailored exercise training can improve cardiorespiratory fitness and enable a meaningful increase in the ability to participate in a wider range of physical activities of daily living; a powerful message to incentivise patients.
这一观点旨在描述慢性肾脏病（CKD）患者峰值摄氧量（V̇Opeak）的演变情况，阐述其对患者进行日常生活体力活动能力的影响，并阐述在这方面运动训练的意义。对4889例患者的文献数据分析表明，预计的V̇Opeak百分比从CKD 2期的69%±10%降至CKD 5期的51%±9%，移植后12个月后部分恢复至60%±12%。同样，以相对于体重的摄氧量表示的V̇Opeak在CKD 2 - 5期从24.7±4.1降至18.0±3.4 mL/kg/min，移植后12个月后部分恢复至21.6±4.9 mL/kg/min。在每个不同疾病阶段报告的V̇Opeak水平存在相当大的变异性。在相当一部分患者中，心肺适能受损导致进行常见体力活动（如快走、将杂货搬上楼、修剪草坪或与（外）孙进行剧烈玩耍）受到限制。量身定制的运动训练可以改善心肺适能，并切实提高参与更广泛日常生活体力活动的能力；这是激励患者的有力信息。
