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Exercise, Bone Disease and Chronic Kidney Disease

by Patricia Gordon, R.N., Ph.D

Disturbances in mineral and bone metabolism occur early in the course of chronic kidney disease (CKD). Without prevention or treatment these disturbances progress to renal osteodystrophy encompassing varying combinations and degrees of high- and low-turnover bone disorders.

Although a broad body of literature indicates that load-bearing exercise has favorable effects on bone metabolism in the adult and aged skeleton [1, 2], there are no studies on the impact of exercise on bone in chronic or end stage renal disease (ESRD). However, much of what is known regarding the effects of exercise on bone, particularly in osteoporosis, may be helpful in the preservation of bone strength in these populations. This may be especially relevant due to the contribution of age-associated osteoporosis as the average age of CKD and ESRD patients increases.

While high impact activity is especially osteogenic [3], moderate intensity walking results in modest increases in lumbar bone mineral density (BMD) [4], indicating that low-impact activities can have a beneficial effect. This is an important consideration for individuals with kidney disease since they are prone to fatigue and generally have low exercise capacity [5]. Read more…

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