Home exercise with telehealth support improved function in stage 4–5 CKD

Design

Prospective, parallel-group randomised controlled trial

Population

54 adults ≥45 with non-dialysis stage 4–5 CKD, Türkiye

Primary outcome

Change in 6-minute walk distance at 12 weeks

Effect

+29.4 m vs −19.3 m (P < .001)

This Turkish randomised trial allocated 54 patients aged 45 or over with non-dialysis stage 4–5 CKD to a 12-week home exercise programme supported by a web platform or video calls, or to usual nephrology care. Fifty-one completed it.

Six-minute walk distance rose by about 29 metres with exercise and fell by about 19 metres with usual care, a difference of nearly 50 metres that held after adjustment. Sarcopenia risk, fatigue, mood, sleep and quality of life also improved.

The trial is small, short and unblinded, but the direction fits a large body of evidence that exercise helps people with CKD. Home programmes avoid travel and are easy to deliver by phone or video, which suits patients far from a renal unit.

• Encourage regular exercise in advanced CKD rather than advising rest.
• Consider a structured home programme with phone or video support.
• Combine aerobic and resistance exercise to address sarcopenia.
• Screen for fatigue and low mood, which also improved with exercise.

Why it matters

Physical decline in advanced CKD is common and partly reversible with simple measures.

Don't overread it

With 51 patients and 12 weeks, it shows functional gains, not effects on kidney function or survival.

The statistics, in plain English

A between-group difference of nearly 50 metres in six-minute walk is clinically meaningful in this population, but small trials can overestimate effects.

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