Chronic Kidney Disease and Physical Activity

Chronic kidney diseases are collectively characterized by abnormal kidney function or structure that persists for at least 3 months. The natural history of chronic kidney diseases is a progressive decline in kidney function over time. While many patients progress to end-stage renal disease with its grave consequence of requirement of dialysis or renal transplant for survival, all these patients are at high risk of cardiovascular complications and death. The prevalence of chronic and end-stage kidney diseases is increasing in the United States. There are several factors that commonly increase the risk of their development, including hypertension, both type I and II diabetes mellitus, dyslipidemia, and obesity. The majority of these risk factors have been shown to be favorably impacted by a healthy lifestyle. The role of improvements in physical activity, exercise, and cardiorespiratory fitness in positively impacting these risk factors is well established. Lifestyle interventions, including exercise, have been proposed to reduce morbidity and mortality in this population. Large epidemiological studies have demonstrated benefits in quality of life, physical endurance, and depression. However, interventional data remains limited. More rigorous, prospective trials are needed to determine the effect and optimal exercise strategy for these patients. This chapter will discuss the impact of physical activity, exercise, and cardiorespiratory fitness on prevention and progression of chronic kidney diseases.