The relevance of the exercise science professional in managing patients with chronic kidney disease
Keywords:
exercise, health promotion, kidney diseases, health professionalsAbstract
Chronic kidney disease (CKD) is a major pathology that directly affects the kidney function and the quality of life of those suffering from it. Managing this disease requires a multidisciplinary effort in which the participation, input, advice and intervention of health professionals is effective. In this case, the role of an exercise science professional becomes relevant, due to the benefits caused by systematic physical activity and exercise on CKD patients. The objective of this study is to show how an exercise professional contributes to an improvement in the patient's health and, therefore, in their quality of life. Nevertheless, particular emphasis is placed on exercise professionals, who are trained to prescribe and implement various specific physical activity programs for patients with CKD. This is based on the benefits of regular exercise on patients, foremost among which are the improvement in cardiovascular function, weight control, blood pressure reduction, adequate levels of cholesterol and triglycerides, improvements in metabolic status and education of patients in keeping healthy habits. The conclusion is that an active involvement of exercise professionals is essential for holistic rehabilitation of CKD patients in all their stages (pre-dialysis, dialysis, and kidney transplant). These professionals allow the safe and adequate prescription of individualized exercise programs, with positive results in muscle mass, functional ability, cardiovascular condition, quality of life and morbimortality reduction. In addition, the study emphasizes the need to overcome organizational and formational barriers, and to consolidate an interdisciplinary approach to incorporate exercise as a key therapeutic intervention.
Downloads
References
Araya, A. V., Bezanilla, C. G., Figueroa, M., Pino, J., Cancino, J., y Mackenney, B. (2023). Efectos de una rutina de ejercicios de resistencia aplicada a pacientes con enfermedad renal crónica durante la hemodiálisis. Revista Médica Clínica Las Condes, 34(1), 92-98. https://doi.org/10.1016/j.rmclc.2022.12.002
Arazi, H., Mohabbat, M., Saidie, P., Falahati, A., y Suzuki, K. (2022). Effects of Different Types of Exercise on Kidney Diseases. Sports, 10(3), 42. https://doi.org/10.3390/sports10030042
Bai, Y., Huang, L., Yin, X., Sun, Q., y Zhang, F. (2024). Effects of whole-body vibration exercise on physical function in patients with chronic kidney disease: a systematic review and meta-analysis. BMC Nephrology, 25(1), 2. https://doi.org/10.1186/s12882-023-03436-3
Battaglia, Y., Baciga, F., Bulighin, F., Amicone, M., Mosconi, G., Storari, A., Brugnano, R., Pozzato, M., Motta, D., D'alessandro, C., Torino, C., Mallamaci, F., Cupisti, A., Aucella, F., Capitanini, A., y Working Group of Physical Exercise of Italian Society of Nephrology (2024). Physical activity and exercise in chronic kidney disease: consensus statements from the Physical Exercise Working Group of the Italian Society of Nephrology. Journal of nephrology, 37(7), 1735–1765. https://doi.org/10.1007/s40620-024-02049-9
Bishop, N. C., Burton, J. O., Graham-Brown, M. P. M., Stensel, D. J., Viana, J. L., y Watson, E. L. (2023). Exercise and chronic kidney disease: potential mechanisms underlying the physiological benefits. Nature reviews Nephrology, 19(4), 244-256. https://doi.org/10.1038/s41581-022-00675-9
Cabrera, V. D., y Rodríguez Espinosa, J. R. (2023). Fundamentación de los efectos benéficos del ejercicio aeróbico en pacientes con enfermedad renal crónica. Revista Cubana de Reumatología: RCuR, 25(4), e1199. https://dialnet.unirioja.es/servlet/articulo?codigo=9454590
Çakal, B., Yıldırım, M., y Emren, S. V. (2022). Kinesiophobia, physical performance, and health-related quality of life in patients with coronary artery disease. Advances in interventional cardiology, 18(3), 246-254. https://doi.org/10.5114/aic.2022.122892
Castle, E. M., Billany, R. E., Lightfoot, C. J., Annema, C., De Smet, S., Graham-Brown, M. P. M., y Greenwood, S. A. (2023). Exercise as a therapeutic intervention in chronic kidney disease: are we nearly there yet? Current opinion in nephrology and hypertension, 32(6), 502-508. https://doi.org/10.1097/MNH.0000000000000923
Chen, C. -C., Huang, Y. -Y., Li, X.-Q., Long, Y.-Q., Chen, Z. -W., y Jin, T. (2024). Impact of resistance exercise on patients with chronic kidney disease. BMC nephrology, 25(1), 115. https://doi.org/10.1186/s12882-024-03547-5
Chinnappa, S., Shih, M. C., Tu, Y. K., y Mooney, A. (2023). The Interpretation of Standard Cardiopulmonary Exercise Test Indices of Cardiac Function in Chronic Kidney Disease. Journal of clinical medicine, 12(23), 7456. https://doi.org/10.3390/jcm12237456
Cigarroa, I., Barriga, R., Michéas, C., Zapata-Lamana, R., Soto, C., y Manukian, T. (2016). Efectos de un programa de ejercicio de fuerza-resistencia muscular en la capacidad funcional, fuerza y calidad de vida de adultos con enfermedad renal crónica en hemodiálisis. Revista médica de Chile, 144(7), 844-852. https://doi.org/10.4067/s0034-98872016000700004
Clyne, N., y Anding-Rost, K. (2021). Exercise training in chronic kidney disease-Effects, expectations and adherence. Clinical kidney journal, 14(Suppl 2), ii3–ii14. https://doi.org/10.1093/ckj/sfab012
Dąbek, B., Dybiec, J., Frąk, W., Fularski, P., Lisińska, W., Radzioch, E., Młynarska, E., Rysz, J., y Franczyk, B. (2023). Novel Therapeutic Approaches in the Management of Chronic Kidney Disease. Biomedicines, 11(10), 2746. https://doi.org/10.3390/biomedicines11102746
Esteve, V., Carneiro, J., Moreno, F., Fulquet, M., Garriga, S., Pou, M., Duarte, V., Saurina, A. Tapia, I., y Ramírez de Arellano, M. (2017). Efecto de la electroestimulación neuromuscular sobre la fuerza muscular, capacidad funcional y composición corporal en los pacientes en hemodiálisis. Nefrologia, 37(1), 68-77. https://doi.org/10.1016/j.nefro.2016.05.010
Fernández Lara, M. J., Ibarra Cornejo, J. L., Aguas Alveal, E. V., González Tapia, C. E., y Quidequeo Reffers, D. G. (2018). Beneficios del ejercicio físico en pacientes con enfermedad renal crónica en hemodiálisis. Enfermería nefrológica, 21(2), 167-181. https://doi.org/10.4321/S2254-28842018000200008
García-Maset, R., Bover, J., Segura de la Morena, J., Goicoechea Diezhandino, M., Cebollada del Hoyo, J., Escalada San Martín, J., Fácila Rubio, L., Gamarra Ortiz, J., García-Donaire, J.A., García-Matarín, L., Gràcia Garcia, S., Gutiérrez Pérez, M.I., Hernández Moreno, J., Mazón Ramos, P., Montañés Bermudez, R., Muñoz Torres, M., de Pablos-Velasco, P., Pérez-Maraver, M., Suáres Fernández, C., ... y Górriz, J.L. (2022). Documento de información y consenso para la detección y manejo de la enfermedad renal crónica. Nefrologia, 42(3), 233-264. https://doi.org/10.1016/j.nefro.2021.07.010
Gómez Bonilla, J. (2025). Enfoque matemático para la estimación del volumen intravascular en pacientes dializados con enfermedad renal crónica (ERC) [Trabajo de maestría]. Universidad de los Andes. https://hdl.handle.net/1992/75635
Heitman, K., Alexander, M. S., y Faul, C. (2024). Skeletal Muscle Injury in Chronic Kidney Disease-From Histologic Changes to Molecular Mechanisms and to Novel Therapies. International Journal of Molecular Sciences, 25(10), 5117. https://doi.org/10.3390/ijms25105117
Hernández Sánchez, S., Garatachea Vallejo, N., Santos Lozano, A., González-Calvo, G., Brazález Tejerina, M., y García López, D. (2015). Valoración física, condición física y calidad de vida en pacientes con diferentes tratamientos renales sustitutivos. Enfermería Nefrológica, 18(2), 81-88. https://doi.org/10.4321/S2254-28842015000200002
Jiménez-Prieto, C. M., González-Tamajón, R., y Rodolfo Crespo-Montero, R. (2020). Beneficios del ejercicio físico en la sesión de hemodiálisis. Una revisión sistemática. Enfermería Nefrológica, 23(3), 233-243. https://doi.org/10.37551/S2254-28842020024
John, J. N., Chimerenma Ugwu, E., Chinedu Okezue, O., Dominic Ekechukwu, E. N., Mgbeojedo, U. G., Okwudili John, D., y Ezeukwu, A. O. (2023). Kinesiophobia and associated factors among patients with chronic non-specific low back pain. Disability and rehabilitation, 45(16), 2651-2659. https://doi.org/10.1080/09638288.2022.2103747
Junqué Jiménez, A., Esteve Simó, V., Tomás Bernaveu, E., Paz López, O., Iza Pinedo, G., Luceño Solé, I., Lavado Sempere, M. L., y Ramírez de Arellano, M. (2015). Resultado de un programa adaptado de ejercicio físico en pacientes ancianos en hemodiálisis. Enfermería Nefrológica, 18(1), 11-18. https://doi.org/10.4321/s2254-28842015000100002
Junqué-Jiménez, A., Montoya-Ariza, Á., Fernández-Parra, Y., Andreu-Periz, D., y Segura Ortí, E. (2020). Resultados de un programa de ejercicio físico domiciliario en pacientes con enfermedad renal. Enfermería Nefrológica, 23(4), 371-379. https://doi.org/10.37551/s2254-28842020038
Katayıfçı, N., Hüzmeli, İ., İriş, D., y Turgut, F. H. (2024). Impairments of functional exercise capacity, muscle strength, balance and kinesiophobia in patients with chronic kidney disease: a cross-sectional study. BMC nephrology, 25(19). https://doi.org/10.1186/s12882-023-03448-z
Mallamaci, F., Pisano, A., y Tripepi, G. (2020). Physical activity in chronic kidney disease and the EXerCise Introduction To Enhance trial. Nephrology, dialysis, transplantation, 35(Suppl 2), ii18-ii22. https://doi.org/10.1093/ndt/gfaa012
Martín, F. Á. L., y Pallas Álvarez, J. R. (2025, 26 de enero). Ejercicio físico en la enfermedad renal crónica. En V. Lorenzo y J. M. López Gómez (Eds.), Nefrología al día. https://www.nefrologiaaldia.org/660
Martínez-Majolero, V., Urosa, B., y Hernández-Sánchez, S. (2022). Physical Exercise in People with Chronic Kidney Disease-Practices and Perception of the Knowledge of Health Professionals and Physical Activity and Sport Science Professionals about Their Prescription. International journal of environmental research and public health, 19(2), 656. https://doi.org/10.3390/ijerph19020656
Nakamura, K., Sasaki, T., Yamamoto, S., Hayashi, H., Ako, S., y Tanaka, Y. (2020). Effects of exercise on kidney and physical function in patients with non-dialysis chronic kidney disease: a systematic review and meta-analysis. Scientific Reports, 10, 18195. https://doi.org/10.1038/s41598-020-75405-x
Orozco González, C. N., y Camacho López, S. (2021). Efectos del ejercicio físico sobre marcadores antropométricos, fuerza muscular y presión arterial en pacientes con hemodiálisis: una revisión narrativa. Revista de Nutrición Clínica y Metabolismo, 4(4), 98-115. https://doi.org/10.35454/rncm.v4n4.297
Pei, G., Tang, Y., Tan, L., Tan, J., Ge, L., y Qin, W. (2019). Aerobic exercise in adults with chronic kidney disease (CKD): a meta-analysis. International urology and nephrology, 51(10), 1787-1795. https://doi.org/10.1007/s11255-019-02234-x
Ramírez-Reyes, D. R., y Tejeda-Díaz, R. (2022). La calidad de vida en pacientes con enfermedad renal. Revista Científica Arbitrada en Investigaciones de la Salud GESTAR, 5(9 Ed. esp.), 78-93. https://journalgestar.org/index.php/gestar/article/view/72
Stømer, U. E., Klopstad Wahl, A., Gunnar Gøransson, L., y Hjorthaug Urstad, K. (2020). Exploring health literacy in patients with chronic kidney disease: a qualitative study. BMC nephrology, 21(1), 314. https://doi.org/10.1186/s12882-020-01973-9
Segura-Ortí, E., Rodilla-Alama, V., y Lisón, J. F. (2008). Fisioterapia durante la hemodiálisis: resultados de un programa de fuerza-resistencia. Nefrología, 28(1), 67-72. https://www.revistanefrologia.com/es-fisioterapia-durante-hemodialisis-resultados-un-programa-fuerza-resistencia-articulo-X0211699508033146
Taryana, A. A., Krishnasamy, R., Bohm, C., Palmer, S. C., Wiebe, N., Boudville, N., MacRae, J., Coombes, J. S., Hawley, C., Isbel, N., y Thompson, S. (2019). Physical activity for people with chronic kidney disease: an international survey of nephrologist practice patterns and research priorities. BMJ Open, 9(12), e032322. https://doi.org/10.1136/bmjopen-2019-032322v
Tikkanen-Dolenc, H., Wadén, J., Forsblom, C., Harjutsalo, V., Thorn, L. M., Saraheimo, M., Elonen, N., Tikkanen, H. O., Groop, P. H., y FinnDiane Study Group (2017). Physical Activity Reduces Risk of Premature Mortality in Patients With Type 1 Diabetes With and Without Kidney Disease. Diabetes care, 40(12), 1727–1732. https://doi.org/10.2337/dc17-0615
Valenzuela, P. L., Castillo-García, A., Saco-Ledo, G., Santos-Lozano, A., y Lucia, A. (2024). Physical exercise: a polypill against chronic kidney disease. Nephrology, Dialysis Transplantation, 39 (9), 1384-1391. https://doi.org/10.1093/ndt/gfae062
Villanego, F., Arroyo, D., Martínez-Majolero, V., Hernández-Sánchez, S., y Esteve-Simó, V. (2023). Importance of physical exercise prescription in patients with chronic7 kidney disease: results of the survey of the Grupo Español Multidisciplinar de Ejercicio Físico en el Enfermo Renal [Spanish Multidisciplinary Group of Physical Exercise in Kidney Patients] (GEMEFER). Nefrologia (English Edition), 43(1), 126-132. https://doi.org/10.1016/j.nefroe.2023.03.009
Villanego, F., Naranjo, J., Vigara, L. A., Cazorla, J. M., Montero, M. E., García, T., Torrado, J., y Mazuecos, A. (2020). Impacto del ejercicio físico en pacientes con enfermedad renal crónica: revisión sistemática y metaanálisis. Nefrología, 40(3), 237-252. https://doi.org/10.1016/j.nefro.2020.01.002
Wilkinson, T. J., Shur, N. F., y Smith, A. C. (2016). "Exercise as medicine" in chronic kidney disease. Scandinavian journal of medicine & science in sports, 26(8), 985-988. https://doi.org/10.1111/sms.12714
Xu, C., Tsihlis, G., Chau, K., Trinh, K., Rogers, N. M., y Julovi, S. M. (2024). Novel Perspectives in Chronic Kidney Disease-Specific Cardiovascular Disease. International Journal of Molecular Sciences, 25(5), 2658. https://doi.org/10.3390/ijms25052658
Yepes Delgado, C. E. M., Montoya Jaramillo, B. E., Orrego Orozco, M. H., Cuellar Santaella, J. J., Yepes Nuñez, J. P., López Muñóz, M. V., Salguero Bermonth, R. D., y Gómez Arias, R. D. (2009). Calidad de vida en pacientes con enfermedad renal crónica sin diálisis ni trasplante de una muestra aleatoria de dos aseguradoras en salud: Medellín, Colombia, 2008. Nefrología (Madrid), 29(6), 548-556. https://scielo.isciii.es/scielo.php?script=sci_arttext&pid=S0211-69952009000600010
Zhang, F., Liu, S., Bai, Y., Huang, L., Zhong, Y., y Li, Y. (2024). Exercise training and chronic kidney disease: characterization and bibliometrics of citation classics of clinical intervention trials. Renal failure, 46(1). https://doi.org/10.1080/0886022X.2024.2349187
Zoccali, C., Mallamaci, F., Adamczak, M., de Oliveira, R. B., Massy, Z. A., Sarafidis, P., Agarwal, R., Mark, P. B., Kotanko, P., Ferro, C. J., Wanner, C., Burnier, M., Vanholder, R., y Wiecek, A. (2023). Cardiovascular complications in chronic kidney disease: a review from the European Renal and Cardiovascular Medicine Working Group of the European Renal Association. Cardiovascular research, 119(11), 2017–2032. https://doi.org/10.1093/cvr/cvad083
