Exercise in individuals with CKD.
Exercise in individuals with CKD.
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DOI：
10.1053/j.ajkd.2011.10.008
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发表时间：
2012-01
期刊：
影响因子：
--
通讯作者：
Painter P
中科院分区：
文献类型：
--
作者：
Johansen KL;Painter P
很少有研究评估非透析慢性肾脏病（CKD）人群的运动。本综述涵盖了不需要透析的CKD患者运动的基本原理以及运动训练对身体功能、肾脏疾病进展和心血管风险因素的影响。此外，我们还讨论了运动的风险问题，并提出了在这一人群中实施运动的建议。来自非对照研究和小型随机对照试验的证据表明，运动训练可改善CKD患者的身体表现和功能。此外，虽然没有研究检查心血管结局，但一些研究表明，心血管危险因素，如高血压，炎症和氧化应激，可以通过运动训练改善这一人群。虽然目前的文献不允许关于运动训练是否减缓肾脏疾病进展的明确结论，但没有研究报告运动训练导致肾功能恶化。在缺乏针对CKD人群的指南的情况下，应将针对老年人和慢性病患者制定的最新指南应用于CKD人群。总之，如果以中等强度开始并逐渐增加，运动在该患者人群中似乎是安全的。事实上，有证据表明，保持不活动的风险更高。应建议患者在可能的情况下增加体力活动，并在适当的情况下进行物理治疗或心脏康复计划。
There are few studies evaluating exercise in the nondialysis chronic kidney disease (CKD) population. This review covers the rationale for exercise among patients with CKD not requiring dialysis and the effects of exercise training on physical functioning, progression of kidney disease, and cardiovascular risk factors. In addition, we address the issue of the risk of exercise and make recommendations for implementation of exercise in this population. Evidence from uncontrolled studies and from small randomized controlled trials shows that exercise training results in improved physical performance and functioning among patients with CKD. In addition, although there are no studies examining cardiovascular outcomes, several studies suggest that cardiovascular risk factors such as hypertension, inflammation, and oxidative stress, may be improved with exercise training in this population. Although the current literature does not allow for definitive conclusions about whether exercise training slows the progression of kidney disease, no study has reported worsening of kidney function as a result of exercise training. In the absence of guidelines specific to the CKD population, recent guidelines developed for older individuals and patients with chronic disease should be applied to the CKD population. In sum, exercise appears to be safe in this patient population if begun at moderate intensity and increased gradually. Indeed, the evidence suggests that the risk of remaining inactive is higher. Patients should be advised to increase their physical activity when possible and referred to physical therapy or cardiac rehabilitation programs when appropriate.
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