Benefit and Risk of Exercise Training in Chronic Kidney Disease Patients

  • Masahiro KohzukiEmail author
  • Toshimi Sato
  • Chaeyoon Cho
  • Naoki Yoshida


Chronic kidney disease (CKD) is a worldwide public health problem. In CKD patients, exercise endurance is lowered, and this phenomenon becomes more distinct as the renal dysfunction advances. This is due to the combined effects of uremic acidosis, protein-energy wasting, and inflammatory cachexia, which lead to and are further aggravated by a sedentary lifestyle. Together, these factors result in a progressive downward spiral of deconditioning. This review focuses on the benefits and risks of exercise training in CKD patients. In Japan, we have established the Japanese Society of Renal Rehabilitation in 2011 to evaluate and promote renal rehabilitation (RR). We use a comprehensive approach to RR including physical exercise and psychological, vocational, and dietary counseling. RR is a feasible, effective, and safe secondary prevention strategy following CKD and offers a promising model for new field of rehabilitation. Urgent efforts should be made to increase the implementation rate of the RR.


Chronic kidney disease Rehabilitation Exercise Cardio-renal syndrome Renal protection 


Conflict of Interest

The author declares no conflict of interest.


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Copyright information

© Springer Nature Singapore Pte Ltd. 2020

Authors and Affiliations

  • Masahiro Kohzuki
    • 1
    Email author
  • Toshimi Sato
    • 1
  • Chaeyoon Cho
    • 1
  • Naoki Yoshida
    • 1
  1. 1.Department of Internal Medicine and Rehabilitation ScienceTohoku University Graduate School of MedicineSendaiJapan

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