Early exercise therapy for acute nephrotic syndrome: a randomised clinical trial.
Yuma Hirano, Tomoyuki Fujikura, Tomoya Yamaguchi et al.
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In 30 seconds
This single-centre randomised controlled trial assessed early exercise therapy in hospitalised adults receiving glucocorticoids for acute nephrotic syndrome. Twenty-seven participants were assigned to exercise therapy or standard care, with peak oxygen uptake measured at baseline and 6 weeks. Peak oxygen uptake rose by 3.45 mL/kg/min in the exercise group and 1.00 mL/kg/min with standard care; the adjusted between-group difference was 2.46 mL/kg/min (95% CI, -0.12 to 5.03), which was not statistically significant. The trial found no significant difference in non-remission risk and no evidence of increased risk with exercise.
Key findings
- Peak oxygen uptake increased by 3.45 mL/kg/min in the exercise group (95% CI, 1.22-5.67) and by 1.00 mL/kg/min with standard care (95% CI, -1.14 to 3.14).
- The adjusted between-group difference in peak oxygen uptake at 6 weeks was 2.46 mL/kg/min (95% CI, -0.12 to 5.03), not statistically significant.
- The risk ratio for non-remission was 0.673 (95% CI, 0.266-1.703), with no significant intergroup difference.
Why it matters
Exercise may help address declining physical function during treatment for acute nephrotic syndrome, while the trial did not identify an increased risk of non-remission. However, the between-group estimate for exercise tolerance was imprecise and included no difference. These findings add preliminary evidence to a setting where concerns about proteinuria and kidney function have contributed to avoiding exercise therapy.
What to keep in mind
The trial was single-centre and included only 27 participants; the 6-week between-group estimate was imprecise and not statistically significant.