Exercise as a renal-protective strategy: slowing chronic kidney disease progression and optimising dialysis care (PhD Academy Award)

Abstract

My PhD investigated the effects of resistance training (RT) on physiological, molecular and clinical profile in patients with chronic kidney disease (CKD). This work encompassed six studies, including randomised controlled trials,1 2 epidemiological analyses,3–5 and an umbrella review,6 exploring the role of muscle mass and exercise in preserving renal function and improving health outcomes in patients with CKD across different disease stages. In total, data from over 1000 patients were analysed, covering a wide spectrum of disease severity and intervention strategies. CKD affects >10% of the global population, leading to progressive renal function decline, increased morbidity and high healthcare costs. Muscle loss is prevalent in CKD, contributing to frailty, inflammation and cardiovascular disease, yet exercise remains underutilised in renal care. RT has shown promise in mitigating CKD-related muscle atrophy, but its feasibility and long-term impact remain unclear. My research aimed to fill this gap by evaluating how RT affects renal function, inflammation and metabolic health, with the goal of establishing exercise as a key therapeutic strategy in CKD management. This PhD included a series of experimental and observational studies: