Abstract
Endothelial dysfunction is a major cause of cardiovascular and renal morbidity and mortality in
chronic kidney disease. Exercise poses an attractive intervention for improving endothelial
function in this cohort. This study aimed to evaluate whether a six-month exercise intervention
could improve physical activity and endothelial function in people living with stage 3 – 4 chronic
kidney disease. A randomised controlled pilot study was conducted with 10 CKD patients (60%
male; mean age 59 ± 14 years). Five exercisers received a personalised home aerobic and
resistance exercise schedule led by exercise instructors with weekly virtual meetings. Five
controls received usual care. Data were analysed by repeated measures analysis of variance
with a between factor of group and a within factor of time (baseline and six months), with pconsidered statistically significant. Questionnaire and accelerometer results showed that the
intervention failed to significantly increase physical activity levels from baseline, but significantly
decreased daily sedentary time by 30 ± 50 minutes as compared to an increase of 50 ± 36
minutes in the controls (p=0.062). There were no significant changes in large vessel or
microvascular endothelial function between study groups. This study highlights the challenging
nature of delivering and evaluating exercise interventions in CKD patients during the COVID-19
pandemic. It also highlights the importance of collecting and reporting physical activity measures
alongside primary outcomes in exercise intervention trials. Future studies in this field should
elucidate the optimal intensity, modality, and volume of exercise training to best improve
endothelial function in patients living with CKD.