Clinical Report: Impact of Exercise Interventions on Frailty in NDD-CKD

Overview

This systematic review and meta-analysis found that exercise interventions improve frailty dimensions, cardiorespiratory fitness, and lower limb function in patients with non-dialysis chronic kidney disease (NDD-CKD). Key improvements included increased walking speed and reduced fatigue, alongside enhanced overall cardiorespiratory fitness.

Background

Chronic kidney disease (CKD) affects a significant portion of the global population and is associated with increased cardiovascular mortality and functional impairment. Non-dialysis chronic kidney disease (NDD-CKD) patients often experience frailty, which can lead to adverse health outcomes. Exercise has been proposed as a non-pharmacologic strategy to improve health and functional independence in this population.

Data Highlights

Key Findings

• Exercise interventions significantly improved walking speed (SMD = 0.36, P = 0.03).
• Exercise interventions alleviated fatigue (SMD = 0.34, P = 0.03).
• Overall cardiorespiratory fitness was enhanced (SMD = 0.46, P < 0.001).
• Lower limb function showed significant improvement (SMD = 0.55, P < 0.001).
• Outcomes for absolute body weight, handgrip strength, and general physical activity levels did not reach statistical significance.

Clinical Implications

Clinicians should consider promoting exercise as a strategy to enhance physical functional reserve before dialysis initiation.

Conclusion

Exercise training may improve frailty characteristics and enhance physical function in NDD-CKD patients.

Related Resources & Content

1. MacEachern et al., European Journal of Preventive Cardiology, 2026 -- Impact of Exercise Interventions on Frailty, Cardiorespiratory Fitness, and Lower Limb Function in Patients with Non-Dialysis Chronic Kidney Disease: A Systematic Review and Meta-Analysis
2. Frontiers in Immunology — Effects of exercise interventions on inflammatory biomarker levels in older adults with frailty and/or sarcopenia: a systematic review and meta-analysis
3. Journal of Medical Internet Research (JMIR) — Effectiveness of Digital Health Interventions in Older Adults With Frailty and Sarcopenia: Systematic Review and Meta‐Analysis of Randomized Controlled Trials
4. Journal of Medical Internet Research (JMIR) — Effects of Multicomponent Digital Health Interventions on Multidimensional Physical Activity in Older Adults: Systematic Review, Meta-Analysis, and Meta-Regression of Randomized Controlled Trials
5. KDIGO 2024 CKD Guideline
6. Home-Based Exercise Improves Muscle Oxidative Capacity in Kidney Disease
7. Effects of different exercises on renal and cardiovascular function in adult patients with chronic kidney disease not receiving dialysis: a network meta-analysis | BMC Nephrology | Springer Nature Link