According to a systematic review published in The Cochrane Library, there are several reasons why individuals suffering with chronic kidney disease (CKD) frequently lose fitness and have a hard time performing everyday tasks. However, new research shows evidence that individuals with the disease, including those with a kidney transplant, who take part in regular physical activity can benefit from improved physical fitness, healthier blood pressure, walking further, healthier heart rates, better nutritional characteristics, and higher health-related quality of life, in comparison to individuals who don't engage in physical activity.

An individual is said to have CKD if they have damaged or poorly performing kidneys where the effects last longer than three months, worldwide the disease is a public health problem. There are several causes of damage, such as rheumatic diseases, diabetes, and high blood pressure. Susanne Heiwe from the Karolinska Institute in Stockholm, Sweden, explained: "Their muscles tend to tire quickly, which reduces the amount of exercise they do, but this then further reduces their fitness."

Although over the past three decades several studies have investigated the way exercise affects individuals with CKD, insufficient evidence-based guidelines have been created. To solve this Heiwe and her colleague, Stefan Jacobson, investigated data and results from 45 investigations that met specific inclusion criteria. Combined, these studies consisted of 1,863 participants.

They discovered that individuals with the disease that did not yet need dialysis, kidney transplant recipients and those on dialysis all benefitted from physical exercise, however, they found that different types of exercises produced different types of benefits.

For example, individuals who performed supervised, high intensity, cardiovascular training for 4 to 6 months considerably improved their aerobic capacity compared to participants in the control group. Other investigations revealed that regardless of if the participant was supervised or not, those who performed three months of regular high intensity resistance training or yoga increased muscular strength, however, when a participant was supervised during high intensity resistance training, walking capacity also increased over three months.

"More research is needed so we can discover how to set up exercise programs that get the desired outcomes as efficiently as possible," explains Heiew, who believes that the review will assist renal health-care providers prescribe physical exercise training more frequently and make choices based on evidence as to which type to recommend.

Up till now the majority of the investigations have examined the effects of cardiovascular exercise programs. Heiwe says: "We now need to know more about the effects of resistance training or mixed cardiovascular and resistance training."

Written by Grace Rattue