Written by Marissa Hoen | November 2 2020
This past week I have been doing lots of digging in the scientific literature around all things Kidney and Exercise, thanks to inspiration from my Exercise Physiology course. Some research surprised me, such as the prevalence of Chronic Kidney Disease (CKD). The number of individuals diagnosed with CKD continues to increase, with a global prevalence of about 11-13%1. Both a cause and consequence of CKD includes diabetes and hypertension- and each of these conditions can be improved by exercise2!
What is Chronic Kidney Disease?
CKD is defined as structural or functional damage to the kidneys for 3 months or more3
Identified through increased blood creatinine, immune factors, and proteinuria (proteins excreted in the urine)3
Symptoms are not common in early stages, so regular Doctor’s visits are important for those with cardiovascular or other health concerns
Some Later Stage symptoms include4:
Water retention leading to swollen ankles or hands
Shortness of breath
Fatigue
Muscle Cramps
Weight Loss and Poor Appetite
Blood in your urine (hematuria)
Headaches
What do the Kidneys actually do?5
The Kidneys main function is to filter our blood!
The kidneys remove waste products that our cells make including creatinine, uric acid, and urea
They also filter out excess substances like extra water, sodium, potassium, phosphorus, to be excreted in urine
In addition to filtering, the Kidneys regulate many characteristics of the blood including:
Blood pH
Blood Volume
Blood Pressure
How does exercise impact people with CKD?6
Exercise has been shown to slow kidney disease progression primarily through its influence on other body systems, including the cardiovascular and muscular systems, however there is notable . Exercise promotes:
Decreased systemic inflammation
Lower Blood Pressure
Less blood flow to kidneys during exercise- easing the blood pressure on the kidneys
Decreased arterial stiffness- easing the workload of your heart, helping to lower blood pressure at the kidneys
Increased muscle mass
Increased tolerance to exercise
Improved quality of life
So much more!
Precautions to exercise:
If you were diagnosed with CKD, you may be taking medications such as beta-blockers to help lower your blood pressure. Keep in mind that these lower your heart rate as well, so if you are measuring exercise intensity with your heart rate, you may be unable to reach your target heart rate.
Make sure you take time to warm up before your workout to help moderate the rise in blood pressure!
Some researchers suggest sticking to a continuous moderate intensity aerobic exercise with some lighter resistance training, however new research suggests that more high intensity exercise may be safe for people with CKD8.
As always, talk with your doctor before beginning a new exercise program to ask about hydration levels, exercise-medication interactions, and any other concerns you may have.
Summary:
Exercise has shown to improve health outcomes and quality of life in people with Chronic Kidney Disease. Keep it moving for the health of your kidneys!
References
Hill, N., Fatoba, S., Oke, J., Hirst, J., O’Callaghan, C., Lasseron, D., & Hobbs, F. (2016). Global prevalence of chronic kidney disease- A systematic review and meta-analysis. PLoS One, 11(7), e0158765. https://doi.org/10.1371/journal.pone.015876
Barcellos, F. C., Santos, I. S., Umpierre, D., Bohlke, M., & Hallal, P. C. (2015). Effects of exercise in the whole spectrum of chronic kidney disease: a systematic review. Clinical kidney journal, 8(6), 753–765. https://doi.org/10.1093/ckj/sfv099
Matovinović, M. S. (2009). 1. Pathophysiology and Classification of Kidney Diseases. EJIFCC, 20(1), 2–11.
Symptoms chronic kidney disease. (2019, August 29). NHS. Retrieved October 31, 2020, from https://www.nhs.uk/conditions/kidney-disease/symptoms/
Derrickson, B. (2017). Human Physiology (4 ed.). John Wiley & Sons, Inc.
Gould, D. W., Graham-Brown, M. P., Watson, E. L., Viana, J. L., & Smith, A. C. (2014). Physiological benefits of exercise in pre-dialysis chronic kidney disease. Nephrology (Carlton, Vic.), 19(9), 519-527. doi:10.1111/nep.12285
Sheps, S. (2020, February 12). Beta blockers: How do they affect exercise? Mayo Clinic. https://www.mayoclinic.org/diseases-conditions/high-blood-pressure/expert-answers/beta-blockers/faq-20058369
Beetham, K. S., Howden, E. J., Fassett, R. G., Petersen, A., Trewin, A. J., Isbel, N. M., & Coombes, J. S. (2019). High‐intensity interval training in chronic kidney disease: A randomized pilot study. Scandinavian Journal of Medicine & Science in Sports, 29(8), 1197-1204. doi:10.1111/sms.13436
Image credit can be found here: https://stock.adobe.com/ca/search?k=kidney+cartoon&asset_id=307567493