Potential implications of blood flow restriction exercise on patients with chronic kidney disease: a brief review

Abstract

Combining blood flow restriction (BFR) with exercise is considered a relevant, helpful method in load-compromised individuals and a viable replacement for traditional heavy-load strength training. BFR exercise may be particularly useful for those unable to withstand high mechanical stresses on joints resulting in skeletal muscle dysfunction, such as patients with chronic kidney disease (CKD). Current literature suggests that BFR training displays similar positive health benefits to exercise training alone for CKD patients, including maintenance of muscle strength, glomerular filtration rate maintenance, uremic parameters, inflammatory profile, redox status, glucose homeostasis, blood pressure adjustments, and low adverse reports. In this review of nine studies in CKD patients, we clarify the potential safety and health effects of exercise training with BFR compared to exercise training alone and recommend insights for future research and practical use. Furthermore, we introduce relevant gaps in this emerging field, providing substantial guidance, critical discussion, and valuable preliminary conclusions in this demographic of patients. However, based on the limited studies in this area, more research is necessary to determine the optimal BFR exercise programming.

Keywords: Blood flow restriction; Chronic kidney disease; Inflammation; Renal function; exercise.

Fig. 1

Impact of BFR exercise on health-related outcomes in patients with CKD. The figure was created in the Mind the Graph platform (www.mindthegraph.com). BFR, blood flow restriction; CKD, chronic kidney disease. Adapted from previous studies (Barbosa et al., 2018; Cardoso et al., 2020; Clarkson et al., 2020; Corrêa et al., 2021a; Corrêa et al., 2021b; de Deus et al., 2021; Deus et al., 2022; Dias et al., 2020; Silva et al., 2021).