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Physical activity and living well with kidney disease

NCSEM-EM academics Professor Alice Smith and Dr Tom Wilkinson from the University of Leicester have published an invited editorial in Nature Reviews Nephrology on physical activity and living well in kidney disease.

This was commissioned to coincide with World Kidney Day 2021 on the 11th March, which this year has the theme of Living Well with Kidney Disease.

Regular physical activity can help people to live well with kidney disease, yet the promotion, funding, level of interest, and general support of physical activity remains poor.

Living well with kidney disease is a key outcome for the clinical management of patients and research studies in nephrology. Along with other lifestyle factors, such as maintaining a healthy diet, engagement in physical activity and exercise may be a fundamental facilitator of living well but is undervalued and underused by the kidney community. Physical inactivity is a leading cause of death worldwide and has a considerable role in the rising global incidence of non-communicable diseases, including kidney disease.

Many patients with kidney disease are profoundly inactive; a study that included 5,656 patients with all stages of kidney disease reported that only 6–34% were sufficiently active to meet UK physical activity guidance. Moreover, physical activity worsened concurrently with disease progression, reaching the lowest point in those with kidney failure receiving dialysis. The number of clinical studies investigating the benefits of physical activity for individuals with kidney disease increases year-on-year, but few efforts have been made to implement their findings in ‘real-world’ programmes.

An urgent global need exists to get people to move more. For decades, the myriad benefits of physical activity have been recognised as fundamental to good health and living well in the general population, and patients with kidney disease do not differ in this respect. However, there has been a conspicuous failure to adopt physical activity and exercise advice and interventions into routine kidney care, especially in comparison to established cardiac and respiratory programmes. A recent advancement in the field is the establishment of the Global Renal Exercise Network, an international collaborative of researchers, patients and clinicians with the overarching objectives of promoting the uptake of physical activity in clinical care and providing a multidisciplinary network to address key global priorities. Physical activity has an important role for patients with kidney disease and researchers and clinicians must act strategically to help them move more and live well.