Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2018 Oct;22(5):1108-1115.
doi: 10.1007/s10157-018-1562-6. Epub 2018 Mar 19.

Practice pattern of physician's directions of exercise restriction in patients with chronic kidney disease: results from the Chronic Kidney Disease Japan Cohort study

Hiroki Nishiwaki  1   2 , Takeshi Hasegawa  3   4   5 , Megumi Shinji  6 , Fujio Matsuo  6 , Tsuyoshi Watanabe  7 , Hirofumi Makino  8 , Fumihiko Koiwa  1 , Akira Hishida  9
Affiliations

Practice pattern of physician's directions of exercise restriction in patients with chronic kidney disease: results from the Chronic Kidney Disease Japan Cohort study

Hiroki Nishiwaki et al. Clin Exp Nephrol. 2018 Oct.

Abstract

Background: The practice patterns of exercise restrictions for patients with chronic kidney disease have not been adequately evaluated yet; thus, we examined them using a cross-sectional design and explored the factors related with those restrictions.

Methods: The Chronic Kidney Disease Japan Cohort study was a multicentre cohort study of Japanese patients (age 20-75 years) living in Japan. We used the information in the questionnaire on the restriction of physical activities offered by physicians to the patients during enrolment. We initially considered and used the following data as the clinical factors that the physician used for decision making on the directions of restriction of physical activities: age, sex, cause of chronic kidney disease (CKD), comorbid diseases, body mass index (BMI), systolic blood pressure, estimated glomerular filtration rate (eGFR) and urine albumin. The logistic regression model was used to explore the factors and estimate their adjusted odds ratio with regard to physician's direction of restriction of physical activities.

Results: Physician's direction of exercise restrictions was implemented in 9.9% of the participants. In 17 facilities, the proportion of physician's direction of exercise restriction ranged from 2.9 to 17.8%. The logistic regression analysis showed that the proportion of the factors such as younger age, cardiovascular disease, congestive heart failure and lower eGFR was higher in patients with physician's direction of exercise restrictions.

Conclusions: The findings from this study suggested the factors related with prescribing exercise restrictions. Further studies examining which patients with CKD need direction of exercise restrictions are needed.

Keywords: Adult; Chronic kidney disease; Exercise restrictions; Physical activities; Practice pattern.

PubMed Disclaimer

Conflict of interest statement

Conflict of interest

The CKD-JAC study was supported by research funds with no restriction on publication from Kyowa Hakko Kirin Co., Ltd. Grants received: Hiroki Nishiwaki (Kyowa Hakko Kirin), Tsuyoshi Watanabe(Kyowa Hakko Kirin). Consultancies: Takeshi Hasegawa (Kyowa Hakko Kirin). Honoraria: Takeshi Hasegawa (Kyowa Hakko Kirin, Baxter, Pfizer, Takeda and Novartis), Hirofumi Makino (Kyowa Hakko Kirin). Employment: Megumi Shinji and Fujio Matsuo (Statistical analyses provided by statisticians M.S. and F.M. from Statcom Company were funded by KHK Pharmaceuticals.)

Ethical approval

All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee at which the studies were conducted (IRB Approval Number 2,007,578 in Showa University Fujigaoka Hospital) and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards.

Informed consent

Informed consent was obtained from all individual participants included in the study.

Figures

Fig. 1
Fig. 1
Rate of the exercise restrictions by the facilities. Facility A–E: 1st tertile, F–K: 2nd tertile, L–Q: 3rd tertile
See this image and copyright information in PMC

Similar articles

See all similar articles

Cited by

References

    1. Centers for Disease Control and Prevention. Physical activity and health: a report of the Surgeon General. 1999. http://www.cdc.gov/nccdphp/sgr/index.htm. Accessed 22 Jul 2016.
    1. Poortmans JR. Exercise and renal function. Sports Med. 1984;1:125–153. doi: 10.2165/00007256-198401020-00003. - DOI - PubMed
    1. Fuiano G, Mancuso D, Cianfrone P, Comi N, Mazza G, Marino F, Fuiano L, Zamboli P, Caglioti A, Andreucci M. Can young adult patients with proteinuric IgA nephropathy perform physical exercise? Am J Kidney Dis. 2004;44:257–263. doi: 10.1053/j.ajkd.2004.04.030. - DOI - PubMed
    1. Eidemak I, Haaber AB, Feldt-Rasmussen B, Kanstrup IL, Strandgaard S. Exercise training and the progression of chronic renal failure. Nephron. 1997;75:36–40. doi: 10.1159/000189497. - DOI - PubMed
    1. Van Craenenbroeck AH, Van Craenenbroeck EM, Van Ackeren K, Vrints CJ, Conraads VM, Verpooten GA, Kouidi E, Couttenye MM. Effect of moderate aerobic exercise training on endothelial function and arterial stiffness in CKD stages 3–4: a randomized controlled trial. Am J Kidney Dis. 2015;66:285–296. doi: 10.1053/j.ajkd.2015.03.015. - DOI - PubMed