Systematic Review of Exercise Interventions and HRQOL in Predialysis CKD
In brief
11 of 16 exercise trials reported better quality of life before dialysis
In a review of 16 randomized trials, 11 reported improved quality of life after exercise, especially in physical and social areas; five found no significant change. Programs were usually walking-based, but varied in frequency, duration and outcome measures, so the findings do not establish which exercise approach works best or whether reported gains are clinically meaningful.
- Journal
- Kidney international reports (Q1)
- Published
- 19 August 2026
- Study design
- Systematic review / meta-analysis of RCTs
- Evidence level
- Level 1, High (CEBM 1a)
- Authors
- Redondo-Saenz Diego, Ratner Stephanie, Patel Lyla, Mendieta Miguel, Shirazian Shayan, Bronas Ulf G
- PMID
- 42780934
- DOI
- 10.1016/j.ekir.2026.107036
Why clinicians should know about it
- Picked for Nephrology (top studies of the week, 27 September 2026): Exercise improves HRQOL in predialysis CKD
Abstract
INTRODUCTION: Health-related quality of life (HRQOL) is frequently impaired among individuals with chronic kidney disease (CKD), even before dialysis initiation. Exercise has been proposed as a strategy to improve HRQOL, but the extent of this association remains unclear in patients with predialysis CKD. This systematic review aimed to characterize the literature examining the relationship between exercise and HRQOL in patients with predialysis CKD. METHODS: A systematic review was conducted, guided by Preferred Reporting Items for Systematic Reviews and Meta-Analysis guidelines and its extension for reviews without meta-analysis. PubMed and Embase were searched in August 2025. Eligible studies included observational or interventional studies assessing physical activity or exercise among patients with CKD stages 1-5 (not on dialysis) and reporting HRQOL outcomes. RESULTS: A total of 18 publications representing 16 randomized controlled trials met the inclusion criteria. Most studies evaluated aerobic exercise interventions, typically walking-based programs performed for 30-60 minutes, 2-4 times per week for 12 weeks to 6 months. HRQOL was assessed using standardized patient-reported outcome measures. Eleven studies reported improvements in HRQOL after exercise interventions, primarily in physical and social domains, including improvements in fatigue, sleep quality, pain, uremic symptoms, social functioning, and social interaction, whereas 5 studies reported no significant change. CONCLUSION: Exercise interventions appear to improve HRQOL among patients with predialysis CKD, particularly in physical and social domains, although heterogeneity in interventions and outcome measures limits comparability. Future interventions should aim for clinically meaningful improvements besides statistical significance.
Abstract as published, via PubMed.
For healthcare professionals. The summary is generated by AI from the published abstract, and the evidence level is assigned automatically from the study design on the Oxford CEBM hierarchy. Neither is medical advice. Read the full paper before changing practice.