A renal rehabilitation exercise program improves physical function and quality of life over 12 weeks in patients with pre-dialysis chronic kidney disease (CKD), a new study suggests.

For the study, published online ahead of print in the Clinical Journal of the American Society of Nephrology, Ana P. Rossi, MD, of Maine Medical Center in Portland, and colleagues randomly assigned 107 men and women with stage 3 or 4 CKD to usual care with or without twice-a-week exercise training.

Fifty-nine participants were guided in cardiovascular exercises such as treadmill walking and stationary cycling, along with stretching and weight training exercises, with the aim to increase duration and/or intensity over time. Exertion was limited to about 65% of maximum heart rate; those with a history of cardiac symptoms were specially assigned to cardiac rehabilitation facilities. Subjects also received pedometers and were encouraged to exercise on their own.

Continue Reading

After 12 weeks, participants in the renal rehabilitation exercise group reported improvement in physical function: longer distances on a 6 minute walk test (19% improvement) and greater muscle strength on a sit-to-stand test (29% improvement). Subjects also perceived better physical function, energy levels, and general health. The control group reported no significant changes.

The exercise program was generally well-tolerated, although not everyone completed all 24 sessions. The exercise trainers also required significant teaching and reassurance to coach this patient population.

“Given the multiple comorbidities of the CKD population, the implementation of a successful exercise program requires a multidisciplinary approach, including clearance from a primary care provider, cardiologist or surgeon before beginning [renal rehabilitation exercise] and collaboration with the exercise or cardiac rehabilitation facility staff,” the study authors said.


  1. Rossi AP et al. Clin J Am Soc Nephrol. 2014; doi: 10.2215/​CJN.11791113.