Sedentary lifestyle is associated with increased incidence of diabetes mellitus, whereas exercise training improves metabolic control and therefore may contribute to prevention of various chronic complications. Diabetic kidney disease is the most common microvascular complication of diabetes mellitus, and is associated with increased mortality from cardiovascular disease in diabetic patients. The literature highlights oxidative stress, renal inflammation, and activation of the renin-angiotensin-aldosterone system as the main pathophysiological mechanisms underlying tissue damage, extracellular matrix accumulation, and renal function deficit. Unfortunately, although the benefits of exercise training on cardiovascular diseases are well established, their impact on the pathophysiological mechanisms involved in the development and progression of diabetic kidney disease is not well understood. In addition, standardization of experimental models and physical rehabilitation programs in diabetic kidney disease are scarce. In this article, we present a brief review of the pathogenesis and pathophysiological mechanisms of diabetic kidney disease,and bring to light the latest findings in the literature on the impact of exercise training on diabetic kidney disease progression.

Impact statement

Diabetic kidney disease (DKD) is associated with increased mortality in diabetic patients and has a negative impact on public health. The identification of potential therapies that help the management of DKD can contribute to the improvement of health and quality of life of patients. Thus, this paper is timely and relevant because, in addition to presenting a concise review of the pathogenesis and major pathophysiological mechanisms of DKD, it addresses the most recent findings on the impact of exercise training on this disease. Thus, since non-pharmacological interventions have gained increasing attention in the fight against chronic diseases, this paper appears as an important tool to increase knowledge and stimulate innovative research on the impact of exercise on kidney disease.

中文翻译：

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运动训练对糖尿病肾病的影响：简要的生理学方法。

久坐的生活方式与糖尿病发病率增加有关，而运动训练可以改善代谢控制，因此可能有助于预防各种慢性并发症。糖尿病肾病是糖尿病最常见的微血管并发症，与糖尿病患者心血管疾病死亡率增加有关。文献强调氧化应激、肾脏炎症和肾素-血管紧张素-醛固酮系统的激活是组织损伤、细胞外基质积累和肾功能缺陷的主要病理生理机制。不幸的是，尽管运动训练对心血管疾病的益处已得到充分证实，但其对糖尿病肾病发生和进展的病理生理机制的影响尚不清楚。此外，糖尿病肾病的实验模型和身体康复计划的标准化也很缺乏。在本文中，我们对糖尿病肾病的发病机制和病理生理机制进行了简要回顾，并揭示了运动训练对糖尿病肾病进展影响的最新文献研究结果。

 影响报告

糖尿病肾病（DKD）与糖尿病患者死亡率增加相关，并对公众健康产生负面影响。确定有助于 DKD 管理的潜在疗法有助于改善患者的健康和生活质量。因此，本文是及时且相关的，因为除了对 DKD 的发病机制和主要病理生理机制进行简明回顾外，它还讨论了运动训练对该疾病影响的最新发现。因此，由于非药物干预措施在对抗慢性病方面受到越来越多的关注，本文似乎成为增加关于运动对肾脏疾病影响的知识和刺激创新研究的重要工具。