Patients with chronic kidney disease (CKD) may benefit considerably from supervised lifestyle therapies that increase physical activity and fitness. For a study, researchers conducted a randomized clinical study in 160 patients with stage 3–4 CKD to test the efficacy of a lifestyle intervention in improving cardiorespiratory fitness and exercise capacity over 36 months. About 81 patients were assigned to standard care and 79 to 3-year lifestyle intervention. A nephrologist, nurse practitioner, exercise physiologist, dietician, diabetes educator, psychologist, and social worker provided treatment as part of the lifestyle intervention. The exercise training component included an 8-week customized and supervised gym-based exercise intervention followed by 34 months of mostly home-based exercise.  At 12, 24, and 36 months, participants’ self-reported physical activity (metabolic equivalent of tasks [METs] minutes per week), cardiorespiratory fitness (peak O2 consumption [VO2peak]), exercise capacity (maximum METs and 6-minute walk distance), and neuromuscular fitness (grip strength and get-up-and-go test time) were assessed.

The intervention raised the percentage of patients fulfilling 500 MET min/wk physical activity guidelines from 29% at baseline to 63% after 3 years. At 12 months, the lifestyle intervention group’s VO2peak and METs rose by 9.7% and 30%, respectively, whereas the usual care group showed no change. At 24 and 36 months, VO2peak returned to near baseline levels, however, METs remained higher in the lifestyle intervention group. The intervention had boosted the 6-minute walk distance and reduced reductions in the get-up-and-go test time after three years. A three-year lifestyle intervention quadrupled the percentage of CKD patients fulfilling physical activity criteria, increased exercise capacity, and reduced neuromuscular and cardiorespiratory fitness deficits.