Exercise Intervention in Patients With Metabolic Syndrome and Renal Disease: a Prospective Study

Exercise Intervention in Patients With Metabolic Syndrome and Renal Disease: a Prospective Study (EXRED)

INTRODUCTION: Obesity (OB) and metabolic syndrome (MetS) are risk and progression factors for chronic kidney disease (CKD). However, the effect of OB/MetS intervention with exercise on renal function progression and proteinuria is unknown.

OBJECTIVE: To analyse the effect of therapeutic exercise on MetS and main renal outcomes in patients with CKD.

METHODOLOGY: This is a 6-month prospective exploratory study. Patients with stablished CKD (1-4) and MetS were treated with individualised incremental exercise (aerobic and resistance). Simultaneously, a plan of adherence was set up to promote compliance. Renal and metabolic outcomes were collected. The main renal parameters were: proteinuria, in isolated urine samples, and glomerular filtration rate (GFR), measured by iohexol DBS, at 0, 3 and 6 months. At the same time points, metabolic outcomes were measured: weight, dyslipidemia, insulin resistance and hypertension.

Inclusion Criteria:

• age >18 years
• CKD of diverse aetiologies
• estimated GFR ≥ 30 ml/min
• BMI ≥ 27 kg/m2 associated to MetS or diabetes mellitus (DM)
• stable renal function for at least 6 months before screening
• ability to perform exercise

Exclusion Criteria:

• clinical conditions that exclude exercise therapy such as clinical instability, active infection, cancer, acute cardiovascular disease, advanced CKD, pulmonary hypertension, or limb amputations
• inability to understand the protocol
• severe psychiatric illness
• allergy to iodine