Impact of a physical activity program for psychophysical well-being in the dialysed and transplanted patient: a pilot study
Accepted: 7 November 2024
All claims expressed in this article are solely those of the authors and do not necessarily represent those of their affiliated organizations, or those of the publisher, the editors and the reviewers. Any product that may be evaluated in this article or claim that may be made by its manufacturer is not guaranteed or endorsed by the publisher.
Background: Chronic Kidney Disease (CKD) is a worldwide health problem. This study evaluated the effects of Nordic Walking on health and quality of life in patients with CKD.
Materials and Methods: single-centre, non-pharmacological, single-arm pilot study in 15 patients undergoing haemodialysis, peritoneal dialysis, or kidney transplantation. The intervention consisted of 22 Nordic Walking sessions over two and a half months. Pre- and post-intervention assessments included blood pressure, oxygen saturation, bioimpedance analysis, and quality of life. Statistical analysis was performed using Wilcoxon's T-test, with significance p<0.05.
Results: improvements were observed in blood pressure (137.5±19.6 mmHg at T0 vs 130.8±16.3 mmHg at T1, p=0.03), SpO2 (98.5±0.6% vs 99.1±0.3%, p=0.02) and HDL cholesterol (48.8±11.1 mg/dL vs 54.9±19.6 mg/dL, p=0.05). Lean mass increased (73.7±8.9% to 76.1±9.8%, p=0.04) while fat mass decreased (26.3± .9% to 23.9±9.8%, p=0.04). Quality of life scores improved significantly (76.6±14.4 at T0 vs 87.8±6.9 at T1, p=0.01).
Conclusions: Nordic Walking improved cardiovascular health and quality of life in people with CKD. More research is needed to confirm these findings.
Smith AC, Burton JO. Exercise in kidney disease and diabetes: time for action. J Ren Care. 2012;38:52-8. DOI: https://doi.org/10.1111/j.1755-6686.2012.00279.x
Jha V, Garcia-Garcia G, Iseki K, et al. Chronic kidney disease: global dimension and perspectives. Lancet Lond Engl. 2013;382:260-72.
Webster AC, Nagler EV, Morton RL, Masson P. Chronic kidney disease. The Lancet. 2017;389:1238-52. DOI: https://doi.org/10.1016/S0140-6736(16)32064-5
Jha V, Garcia-Garcia G, Iseki K, et al. Chronic kidney disease: global dimension and perspectives. Lancet Lond Engl. 2013;382:260-72. DOI: https://doi.org/10.1016/S0140-6736(13)60687-X
Kovesdy CP. Epidemiology of chronic kidney disease: an update 2022. Kidney Int Suppl. 2022;12:7-11. DOI: https://doi.org/10.1016/j.kisu.2021.11.003
Chen TK, Knicely DH, Grams ME. Chronic kidney disease diagnosis and management. JAMA. 2019;322:1294-304. DOI: https://doi.org/10.1001/jama.2019.14745
Hoshino J. Renal rehabilitation: exercise intervention and nutritional support in dialysis patients. Nutrients. 2021;13:1444. DOI: https://doi.org/10.3390/nu13051444
Zelle DM, Klaassen G, van Adrichem E, et al. Physical inactivity: a risk factor and target for intervention in renal care. Nat Rev Nephrol. 2017;13:318. DOI: https://doi.org/10.1038/nrneph.2017.44
Viana JL, Kosmadakis GC, Watson EL, et al. Evidence for anti-inflammatory effects of exercise in CKD. J Am Soc Nephrol JASN. 2014;25:2121-30. DOI: https://doi.org/10.1681/ASN.2013070702
Avesani CM, Trolonge S, Deléaval P, et al. Physical activity and energy expenditure in haemodialysis patients: an international survey. Nephrol Dial Transplant Off Publ Eur Dial Transpl Assoc - Eur Ren Assoc. 2012;27:2430-4. DOI: https://doi.org/10.1093/ndt/gfr692
Hellberg M, Höglund P, Svensson P, et al. Decline in measured glomerular filtration rate is associated with a decrease in endurance, strength, balance and fine motor skills. Nephrol Carlton Vic. 2017;22:513-9. DOI: https://doi.org/10.1111/nep.12810
Tentori F, Elder SJ, Thumma J, et al. Physical exercise among participants in the Dialysis Outcomes and Practice Patterns Study (DOPPS): correlates and associated outcomes. Nephrol Dial Transplant Off Publ Eur Dial Transpl Assoc - Eur Ren Assoc. 2010;25:3050-62. DOI: https://doi.org/10.1093/ndt/gfq138
Herdman M, Gudex C, Lloyd A, et al. Development and preliminary testing of the new five-level version of EQ-5D (EQ-5D-5L). Qual Life Res Int J Qual Life Asp Treat Care Rehabil. 2011;20:1727-36. DOI: https://doi.org/10.1007/s11136-011-9903-x
Pinckard K, Baskin KK, Stanford KI. Effects of exercise to improve cardiovascular health. Front Cardiovasc Med. 2019;6:69. DOI: https://doi.org/10.3389/fcvm.2019.00069
Heiwe S, Jacobson SH. Exercise training for adults with chronic kidney disease. Cochrane Database Syst Rev. 2011;10:CD003236. DOI: https://doi.org/10.1002/14651858.CD003236.pub2
Bellicha A, van Baak MA, Battista F, et al. Effect of exercise training on weight loss, body composition changes, and weight maintenance in adults with overweight or obesity: an overview of 12 systematic reviews and 149 studies. Obes Rev. 2021;22:e13256. DOI: https://doi.org/10.1111/obr.13256
Roshanravan B, Gamboa J, Wilund K. Exercise and CKD: skeletal muscle dysfunction and practical application of exercise to prevent and treat physical impairments in CKD. Am J Kidney Dis Off J Natl Kidney Found. 2017;69:837. DOI: https://doi.org/10.1053/j.ajkd.2017.01.051
Deligiannis A, D’Alessandro C, Cupisti A. Exercise training in dialysis patients: impact on cardiovascular and skeletal muscle health. Clin Kidney J. 2021;14:ii25-33. DOI: https://doi.org/10.1093/ckj/sfaa273
Bakker EA, Zoccali C, Dekker FW, et al. Assessing physical activity and function in patients with chronic kidney disease: a narrative review. Clin Kidney J. 2020;14:768-79. DOI: https://doi.org/10.1093/ckj/sfaa156
Copyright (c) 2025 Tatiana Bolgeo, Roberta Di Matteo, Menada Gardalini, Antonella Giolito, Tiziana Barocelli, Serena Torti, Antonio Maconi, Marco Quaglia

This work is licensed under a Creative Commons Attribution-NonCommercial 4.0 International License.
PAGEPress has chosen to apply the Creative Commons Attribution NonCommercial 4.0 International License (CC BY-NC 4.0) to all manuscripts to be published.