Work

Home-Based Exercise Improves Muscle Oxidative Capacity in Kidney Disease

Year: 2025

Type: article

Study designs: Randomized Controlled Trial, Clinical Trial

Abstract: Introduction Muscle impairment in chronic kidney disease (CKD) contributes to decreased physical performance, frailty, and increased mortality. This proof-of-concept randomized controlled study evaluated the efficacy of a 12-week home-based, video-supervised exercise program on muscle endurance in moderate-to-severe nondialysis CKD. Methods Thirty-two sedentary adults with CKD (estimated glomerular filtration rate [eGFR] < 60 ml/min per 1.73 m 2 ) were randomized (3:1) to a home exercise group (EX, n = 23) or usual care group (UC, n = 9). The primary outcome was in vivo muscle mitochondrial bioenergetics (rate of phosphocreatine recovery, k PCr ) measured using phosphorus-31 magnetic resonance spectroscopy. Secondary outcomes included 6-minute walk test (6MWT) distance (6MWD), total work, peak oxygen consumption (VO 2 peak), and work efficiency obtained from cardiopulmonary exercise testing (CPET). Other outcomes were body composition and plasma cytokines. Within- and between-group differences were analyzed using linear mixed models (LMMs). Results Mean (SD) ages were 62.6 (10.8) years in EX and 67.2 (8.2) in UC. Mean eGFRs were 35.0 (12.6) and 32.3 (12.0) ml/min per 1.73 m 2 , respectively. No serious adverse events occurred; 90.5% of EX completed ≥ 75% of sessions. Compared with UC, EX significantly increased k PCr (0.20/min, 95% confidence interval [CI]: 0.05–0.35, P = 0.01), total work (5.03 kJ, 95% CI: 1.25–8.80, P = 0.007), and 6MWD (39.1 m, 95% CI: 7.1–71.1, P = 0.014) while preserving fat-free mass (2.3 kg, 95% CI: 0.49–4.1, P = 0.024) and marginally decreasing fat mass (−2.22 kg, 95% CI: −4.7 to 0.27, P = 0.1) . Interleukin (IL)-8 concentration differed between groups (effect size: −1.16, 95% CI: −2.4 to −0.04, P = 0.016). Work efficiency, VO 2 peak, and other cytokines showed no significant differences between groups. Conclusion Home-based, video-supervised exercise is feasible, improves muscle oxidative capacity and endurance, offering a strategy to mitigate functional decline in moderate-to-severe nondialysis CKD.

Source: Kidney International Reports

DOI: 10.1016/j.ekir.2025.103737