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Small amount of exercise can help kidney disease patients, says study

A modest amount of exercise may help reduce kidney disease patients’ risks of developing heart disease and infections, according to a study led by Loughborough University scientists.

Heart disease and infection are major complications and the leading causes of death in patients with chronic kidney disease. It is now well established that immune system dysfunction is involved in both of these pathological processes.

Specifically, impaired immune function predisposes to infection, while persistent immune activation leads to a state of chronic inflammation that can damage the insides of blood vessels and increase heart disease risk.

Physical exercise may confer benefits by exerting anti-inflammatory effects and enhancing immunity, but such effects have been largely unexplored in kidney disease.

João Viana, PhD, Nicolette Bishop, PhD (both from Loughborough University), and Alice Smith, PhD (University of Leicester) and their colleagues designed a study to explore the impact of exercise on a range of immune and inflammatory parameters in patients with chronic kidney disease.

This study has led to research that is now being undertaken by the Leicester-Loughborough Diet, Physical Activity & Lifestyle Biomedical Research Unit (BRU) – a research partnership between Loughborough University and University Hospitals Leicester investigating the role physical activity plays in managing and preventing chronic disease.

It will appear in an upcoming issue of the Journal of the American Society of Nephrology (JASN), and has been published ahead of print.

In an acute exercise study conducted in 15 patients, 30 minutes of walking improved the responsiveness of immune cells called neutrophils to a bacterial challenge in the post-exercise period. It also induced a systemic anti-inflammatory environment in the body.

In a regular exercise study conducted in 20 patients, six months of regular walking (30 minutes per day, five times per week) reduced immune cell activation and markers of systemic inflammation, compared to another 20 patients who did not increase their usual activity levels over the same period of time.

“Thus, exercise exerts anti-inflammatory effects in patients with kidney disease and may in this way reduce their high risk for heart disease,” said Dr Viana.

“Our study also found no evidence that this level of exercise might be harmful to the immune system in people with kidney disease.”

Dr Bishop said: “These findings emphasise the health benefits for kidney patients of including just a relatively modest amount of exercise in their daily life.

“These findings are of credit to our long-term collaboration with the Leicester Kidney Exercise Team as we look forward to translating further high-quality research into patient practice with the long-term aim of establishing appropriate exercise prescription as part of the care package for all kidney patients.”

Study co-authors include George Kosmadakis, Dipl Med, Emma Watson, PhD, Alan Bevington, DPhil, and John Feehally, DM.

The article, entitled ‘Evidence for Anti-Inflammatory Effects of Exercise in CKD,’ can be viewed online at http://jasn.asnjournals.org/content/early/2014/04/02/ASN.2013070702