Aerobic exercise in obese diabetic patients with chronic kidney disease: a randomized and controlled pilot study
Open accessAbstract
BACKGROUND: Patients with obesity, diabetes, and chronic kidney disease (CKD) are generally physically inactive, have a high mortality rate, and may benefit from an exercise program. METHODS: We performed a 24-week randomized controlled feasibility study comparing aerobic exercise plus optimal medical management to medical management alone in patients with type 2 diabetes, obesity (body mass index [BMI] > 30 kg/m2), and stage 2-4 CKD (estimated glomerular filtration rate [eGFR] 15-90 mL/min/1.73 m2 with persistent proteinuria). Subjects randomized to exercise underwent thrice weekly aerobic training for 6 followed by 18 weeks of supervised home exercise. The primary outcome variable was change in proteinuria. RESULTS: Seven subjects randomized to exercise and 4 control subjects completed the study. Exercise training resulted in an increase in exercise duration during treadmill testing, which was accompanied by slight but insignificant decreases in resting systolic blood pressure and 24-hour proteinuria. Exercise did not alter GFR, hemoglobin, glycated hemoglobin, serum lipids, or C-reactive protein (CRP). Caloric intake and body weight and composition also did not change with exercise training. CONCLUSION: Exercise training in obese diabetic patients with CKD is feasible and may have clinical benefits. A large-scale randomized controlled trial to determine the effects of exercise on renal functions, cardiovascular fitness, inflammation, and oxidative stress in diabetic patients with CKD is planned.
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Risk for detection bias was unclear in 4 RCTs and high in the Kiuchi study only.
“Risk for detection bias was unclear in 4 RCTs [7, 13, 20, 21], and was scored as high in Kiuchi study only [15].”
From Exercise therapy improves eGFR, and reduces blood pressure and BMI in non-dialysis CKD patients: evidence from a meta-analysis (2019) · cites this paper as [21]
High risk of performance bias was granted to more than 75% of the included studies.
“high risk of performance bias was granted to more than 75% of the studies [7, 9, 10, 13, 15–18, 20, 21].”
From Exercise therapy improves eGFR, and reduces blood pressure and BMI in non-dialysis CKD patients: evidence from a meta-analysis (2019) · cites this paper as [21]
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References 31 · Cited by 156
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- Authors
- Leehey, D. J., Moinuddin, I., Bast, J. P., Qureshi, S., Jelinek, C. S., Cooper, C., Edwards, L. C., Smith, B. M., & Collins, E. G.
- Affiliations
- United States Department of Veterans Affairs (US)
- Edward Hines, Jr. VA Hospital (US)
- Corresponding author
- Leehey, David J
- Venue
- Cardiovascular Diabetology
- Published
- 2009
- Volume
- 8
- Issue
- 1
- Pages
- 62
- ISSN
- 1475-2840 (ISSN-L)
- PMC
- PMC2796994
- OpenAlex
- W2157677774
- Cited by
- 156
- References
- 31
- Citations by year
- 2026: 8 · 2025: 1 · 2024: 9 · 2023: 7 · 2022: 15 · 2021: 12 · 2020: 13 · 2019: 11 · 2018: 5 · 2017: 8 · 2016: 14 · 2015: 7 · 2014: 16 · 2013: 12 · 2012: 8
- FWCI
- 4.15
- Type
- journal article
- Language
- en
- Open access
- gold
- doi.org
- Licence
- cc-by
- Locations
- Cardiovascular Diabetology (publishedVersion, cc-by)
- PubMed Central (publishedVersion, cc-by)
- PubMed (publishedVersion)
- DOAJ (DOAJ: Directory of Open Access Journals) (submittedVersion, cc-by-sa)
- Topics
- Health Sciences › Medicine › Nephrology › Chronic Kidney Disease and Diabetes
- Health Sciences › Medicine › Complementary and alternative medicine › Cardiovascular and exercise physiology
- Health Sciences › Medicine › Physiology › Physical Activity and Health
- Keywords
- aerobic exercise, type 2 diabetes, obesity, chronic kidney disease, proteinuria, exercise feasibility, HbA1c, blood pressure, energy intake, body composition
- MeSH terms
- Aged, Aged, 80 and over, Blood Pressure, Body Composition, C-Reactive Protein, Energy Intake, Chronic Disease, Creatinine, Diabetes Mellitus, Type 2, Diabetic Nephropathies, Exercise Therapy, Feasibility Studies, Glomerular Filtration Rate, Heart Rate, Hemoglobins, Humans, Kidney, Lipids, Male, Middle Aged, Obesity, Oxygen Consumption, Pilot Projects, Proteinuria, Time Factors, Biomarkers, Body Mass Index, Treatment Outcome, Exercise Tolerance
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