Physical exercise and renal function

Abstract

The kidneys play an important role in regulating acid-base and water-electrolyte balance disturbances induced by exercise. In sports medicine, research on renal function during exercise in healthy individuals and athletes is less common than other areas of study such as the respiratory, circulatory, and neuromuscular systems as well as metabolism, since renal function has no direct effect on athletic performance. In this study, we reviewed previous research results obtained in our laboratory and other studies as follows: 1) effects of exercise intensity on renal plasma flow and glomerular filtration rate; 2) effects of exercise intensity on plasma hormone responses and urinary excretion of water and electrolytes; 3) effects of aging on renal function following exhaustive exercise; 4) mechanisms underlying exercise-induced diuresis in healthy volunteers; 5) mechanisms underlying exercise-induced proteinuria (EIP) in healthy volunteers; and 6) effects of exercise combined with angiotensin-converting enzyme (ACE) inhibitor (ACE-I) on the progression of diabetic nephropathy (DN) in obese diabetic model rats. The number of obese diabetes patients is increasing in advanced countries, and the number of hemodialysis (HD) patients per capita in Japan is the highest worldwide. Approximately 42% of patients with DN undergo HD treatment every year. However, regular exercise has not been positively recommended for patients with nephropathy despite being an essential clinical approach for patients with diabetes. Moreover, the ideal exercise regimen for patients with diabetes complicated by nephropathy has not been investigated much. Therefore, a future study should investigate exercise therapy for patients with DN.