Physical Activity and Exercise for Cardiometabolic Health and Fitness in Chronic Kidney Disease: An Overview by Exercise Type

People with chronic kidney disease (CKD) have a high cardiovascular (CV) disease burden. Physical activity and exercise can improve CV risk, but adaptations are specific to the activity performed. Therefore, changes in individual CV risk factors may be influenced by variables such as the volume and type of exercise. This narrative Review will outline the evidence for the effects of physical activity and exercise type on cardiometabolic risk factors in adults and provide insights for patients and clinicians. Current evidence suggests that changes in risk factors such as cardiorespiratory fitness and body composition demonstrate specificity to exercise type across the CKD spectrum. However, limited data for each exercise type within some sub-groups (e.g., disease stage), trial heterogeneity, and other barriers limit the ability to draw definitive conclusions regarding optimal exercise type for some outcomes. Despite these gaps, evidence supports physical activity and exercise's role in improving CV health in people with CKD. A greater emphasis on activity counselling, multifactorial interventions, and implementation strategies may help to maximize the effects of physical activity and exercise on CV health in people with CKD.