Walking Doesn’t Hurt, May Help in CKD
Frontline Medical News, 2014 Apr 10, MA Moon
Neither acute bouts of moderate walking nor regular moderate walking are unsafe in patients who have predialysis chronic kidney disease, and both types of exercise may actually reduce systemic inflammation and improve immune function in these patients, according to a report published in the Journal of the American Society of Nephrology.
CKD is associated with “a complex state of immune dysfunction in which signs of immune depression and immune activation paradoxically coexist.” Moderate exercise may therefore enhance certain aspects of immune function while simultaneously exerting detrimental effects on other aspects, said Dr. João Viana of the school of sport, exercise, and health sciences, Loughborough (England) University, and his associates.
The investigators studied blood biomarkers of immune function and inflammation in 15 adults with predialysis CKD who participated in a single bout of “somewhat hard” walking on a motorized treadmill for 30 minutes. This induced “a systemic anti-inflammatory environment,” as evidenced by a marked increase in plasma IL-10 levels. It also improved neutrophil responsiveness to an in vitro bacterial challenge during the hour following the exercise. It had no effect on T-lymphocyte or monocyte activation, the researchers said (J. Am. Soc. Nephrol. 2014; April 3; doi:10.1681/ASN.2013070702]).
In a separate analysis, Dr. Viana and his colleagues assessed the same blood biomarkers in 24 participants in a previous study, who had been assigned to either 6 months of regular home-based walking (13 predialysis CKD patients) or to their usual sedentary activity level (11 control subjects). The “exercisers” walked at a “somewhat hard” rate for 30 minutes per day, 5 times per week.
This regular walking also exerted systemic anti-inflammatory effects, as evidenced by a reduction in the IL-6 to IL-10 ratio and downregulation of T-lymphocyte and monocyte activation. It had no effect on circulating numbers of immune cells or on neutrophil degranulation response. Neither acute nor regular walking affected body weight, renal function, proteinuria, or blood pressure.
These findings suggest that walking “is safe from an immune and inflammatory perspective, and exerts anti-inflammatory effects at both systemic and cellular levels” in this patient population. Regular walking “has the potential to be an effective anti-inflammatory therapy in predialysis CKD patients and may in this way reduce the high risk of cardiovascular disease in these very vulnerable patients,” the investigators noted.
The authors reported no financial disclosures.