Supervised lifestyle interventions have the potential to significantly improve physical activity and fitness in patients with CKD.

To assess the efficacy of a lifestyle intervention in patients with CKD to improve cardiorespiratory fitness and exercise capacity over 36 months, we conducted a randomized clinical trial, enrolling 160 patients with stage 3–4 CKD, with 81 randomized to usual care and 79 to a 3-year lifestyle intervention. The lifestyle intervention comprised care from a multidisciplinary team, including a nephrologist, nurse practitioner, exercise physiologist, dietitian, diabetes educator, psychologist, and social worker. The exercise training component consisted of an 8-week individualized and supervised gym-based exercise intervention followed by 34 months of a predominantly home-based program. Self-reported physical activity (metabolic equivalent of tasks [METs] minutes per week), cardiorespiratory fitness (peak O₂ consumption [VO_2peak]), exercise capacity (maximum METs and 6-minute walk distance) and neuromuscular fitness (grip strength and get-up-and-go test time) were evaluated at 12, 24, and 36 months.

The intervention increased the percentage of patients meeting physical activity guideline targets of 500 MET min/wk from 29% at baseline to 63% at 3 years. At 12 months, both VO_2peak and METs increased significantly in the lifestyle intervention group by 9.7% and 30%, respectively, without change in the usual care group. Thereafter, VO_2peak declined to near baseline levels, whereas METs remained elevated in the lifestyle intervention group at 24 and 36 months. After 3 years, the intervention had increased the 6-minute walk distance and blunted declines in the get-up-and-go test time.

A 3-year lifestyle intervention doubled the percentage of CKD patients meeting physical activity guidelines, improved exercise capacity, and ameliorated losses in neuromuscular and cardiorespiratory fitness.

有监督的生活方式干预有可能显着改善 CKD 患者的身体活动和健康状况。

为了评估生活方式干预对 CKD 患者在 36 个月内改善心肺健康和运动能力的疗效，我们进行了一项随机临床试验，招募了 160 名 3-4 期 CKD 患者，其中 81 名随机接受常规治疗，79 名接受常规治疗3 年生活方式干预。生活方式干预包括多学科团队的护理，包括肾病学家、执业护士、运动生理学家、营养师、糖尿病教育者、心理学家和社会工作者。运动训练部分包括为期 8 周的个性化和监督的基于健身房的运动干预，然后是 34 个月的主要在家进行的计划。自我报告的身体活动（每周代谢当量 [MET] 分钟）、心肺健康（峰值 O ₂在 12、24 和 36 个月时评估消耗 [VO _2peak ]）、运动能力（最大 MET 和 6 分钟步行距离）和神经肌肉健康（握力和起身测试时间）。

该干预将达到 500 MET 分钟/周体力活动指南目标的患者百分比从基线时的 29% 提高到 3 年时的 63%。在 12 个月时，生活方式干预组的VO _{2peak和 MET 均显着增加 9.7% 和 30%，而常规护理组没有变化。}此后，VO _2peak下降至接近基线水平，而生活方式干预组的 MET 在 24 个月和 36 个月时仍然升高。3 年后，干预增加了 6 分钟的步行距离，并减缓了起床测试时间的下降。

为期 3 年的生活方式干预使 CKD 患者达到身体活动指南的百分比翻了一番，提高了运动能力，并改善了神经肌肉和心肺健康的损失。