***TASK*** the task is to summarize an input biomedical literature in six sentences 
    ***INPUT*** the input is a biomedical literature 
    ***OUTPUT*** the output is the summary of an input biomedical literature in six sentences 
    ***DOCUMENTATION*** 
    ***EXAMPLES*** 
    Input: BACKGROUND The prevalence of obesity has markedly increased in patients with chronic kidney disease ( CKD ) . Studies on the impact of exercise focusing on obese CKD patients are scarce . Therefore , we aim ed to investigate the effect of aerobic exercise performed either in an exercise centre or at home on visceral fat in overweight non-dialysed CKD patients . METHODS Twenty-seven sedentary men ( 52.1 ± 9.5 years , body mass index 30.4 ± 3.8 kg/m(2 ) , estimated glomerular filtration rate ( eGFR ) 27.5 ± 11.6 mL/min ) were r and omly assigned to a centre-based exercise group ( n = 10 ) , home-based exercise group ( n = 8) or control group ( n = 9 ) . The aerobic training was prescribed according to ventilatory threshold and performed three times per week during 12 weeks . Body composition was assessed by dual energy X-ray absorptiometry ( DEXA ) and the distribution of abdominal fat by computed tomography . RESULTS In the centre-based group , visceral fat and waist circumference decreased 6.4 ± 6.4 mm ( P < 0.01 ) and 2.0 ± 2.3 cm ( P = 0.03 ) and leg lean mass increased 0.5 ± 0.4 kg ( P < 0.01 ) . No significant changes were observed in the home-based group . Visceral fat increased 5.0 ± 4.4 mm in the control group ( P = 0.01 ) . In relation to the control , a group-by-time interaction was significant for visceral fat and waist circumference for both exercise groups and for leg lean mass for the centre-based group . Mean blood pressure decreased in both exercise groups ( centre-based 13 % , P < 0.01 and home-based 10 % , P = 0.03 ) and eGFR increased 3.6 ± 4.6 mL/min ( P = 0.03 ) in the centre-based group . These parameters remained unchanged in the control group . CONCLUSIONS Centre-based aerobic exercise is an effective approach to reduce visceral fat besides promoting relevant clinical benefits in male overweight CKD patients BACKGROUND AND OBJECTIVES CKD is associated with poor  cardiorespiratory fitness ( CRF ) . This predefined sub study determined the effect of exercise training and lifestyle intervention on CRF and explored the effect on cardiovascular risk factors and cardiac and vascular function . DESIGN , SETTING , PARTICIPANTS , & MEASUREMENTS Between February 2008 and March 2010 , 90 patients with stage 3 - 4 CKD were screened with an exercise stress echocardiogram before enrollment . Patients ( n=83 ) were r and omized to st and ard care ( control ) or lifestyle intervention .  The lifestyle intervention included multidisciplinary care ( CKD clinic ) , a lifestyle program , and aerobic and resistance exercise training for 12 months . CRF ( peak Vo2 ) , left ventricular function , arterial stiffness , anthropometric , and biochemical data were collected at baseline and 12 months . RESULTS Ten percent of r and omized patients had sub clinical myocardial ischemia at screening and completed the study without incident . There was no baseline difference among 72 patients who completed follow-up ( 36 in the lifestyle intervention group and 36 in the control group ) . The intervention increased peak Vo2 ( 2.8±0.7 ml/kg per minute versus -0.3±0.9 ml/kg per minute ; P=0.004 ) . There was small weight loss ( -1.8±4.2 kg versus 0.7±3.7 kg ; P=0.02 ) but no change in BP or lipids . Diastolic function improved ( increased e ' of 0.75±1.16 cm/s versus -0.47±1.0 cm/s ; P=0.001 ) but systolic function was well preserved and did not change . The change in arterial elastance was attenuated ( 0.11±0.76 mmHg/ml versus 0.76±0.96 mmHg/ml ; P=0.01 ) . Δ peak Vo2 was associated with group allocation and improved body composition . CONCLUSIONS Exercise training and lifestyle intervention in patients with CKD  produces improvements in CRF , body composition , and diastolic function Background Only a few research is available on the effects of home-based exercise training on pre-dialysis chronic kidney disease ( CKD ) patients . Therefore , we aim ed to eluci date the effect of home-based exercise therapy on kidney function and arm and leg muscle strength in pre-dialysis CKD patients . Methods Thirty-six male stage 3–4 pre-dialysis CKD patients ( age , 68.7 ± 6.8 years ; estimated glomerular filtration rate ( eGFR ) , 39.0 ± 11.6 ml/min/1.73 m2 ) who were being treated as out patients were included . The subjects were r and omly assigned to an exercise intervention group ( Ex group : 18 ) and a control group ( C group : 18 ) . The Ex group wore accelerometer pedometers and were instructed to perform home-based aerobic and resistance exercises , such as brisk walking for 30 min per day , for 12 months . The C group subjects wore accelerometer pedometers but received no exercise therapy guidance ; the number of steps covered during normal daily activities was recorded for the C group . The outcome measures were changes in kidney function and h and grip and knee extension muscle strength . Values at the baseline ( T1 ) and 12 months later ( T2 ) were compared . Results There were no significant differences in baseline characteristics between the two groups ; however , the C group was more physically active than the Ex group . Eight subjects dropped out , and 28 subjects ( 14 in each group ) were included in the final analysis . Physical activity increased significantly only in the Ex group . Grip strength ( F = 7.0 , p = 0.01 ) and knee extension muscle strength ( F = 14.3 , p < 0.01 ) were found to improve only in the Ex group . Further , the changes in eGFR were not significantly different between the two groups ( F = 0.01 , p = 0.93 ) . Conclusions Home-based exercise therapy for pre-dialysis CKD patients was feasible and improved arm and leg muscle strength without affecting kidney function . Trial registration UMIN Clinical Trials Registry ( UMIN000005091 ) . Registered 2/15/2011 BACKGROUND The present study was design ed to determine the effect of short-term moderate-intensity exercise training on arterial stiffness in patients with chronic kidney disease ( CKD ) stage 3 . STUDY DESIGN R and omized controlled trial with a parallel-group design . SETTING & PARTICIPANTS Testing and training sessions were performed at Springfield College . 46 ( treatment group , n=25 ; control group , n=21 ) patients with CKD with diabetes and /or hypertension completed the study . INTERVENTION The aerobic training program consisted of 16 weeks of supervised exercise training at 50%-60 % peak oxygen uptake ( Vo2peak ) 3 times per week , while the control group remained sedentary . Identical testing procedures were performed following the 16-week intervention . OUTCOMES The primary outcome was arterial stiffness . Secondary outcomes were aerobic capacity , various blood parameters ( endothelin 1 , nitrate/nitrite , and high-sensitivity C-reactive protein ) , and health-related quality of life . MEASUREMENTS Arterial stiffness was assessed with aortic pulse wave velocity ( PWV ) , aerobic capacity by Vo2peak , blood parameters by enzyme-linked immunosorbent assays , and health-related quality of life by the 36-Item Short Form Health Survey ( SF-36 ) . Participants attended 4 sessions before being r and omly assigned to either the treatment or control group . Participants gave consent during the first session , whereas a grade d exercise test with measurement of Vo2peak was completed during the second session . During sessions 3 and 4 , aortic PWV was measured at rest prior to 40 minutes of either moderate-intensity exercise training or seated rest . A venous blood sample was obtained prior to exercise or rest and participants completed the SF-36 question naire . RESULTS 16 weeks of training led to an 8.2 % increase in Vo2peak for the treatment group ( P=0.05 ) , but no changes in aortic PWV . LIMITATIONS R and omization was not concealed and was violated on one occasion ; also , use of an indirect measurement of endothelial function and the short duration of the intervention . CONCLUSIONS Short-term moderate-intensity exercise training does not alter arterial stiffness in patients with CKD , but seems to reduce endothelin 1 levels Background Home-based exercise has been shown to provide benefits in terms of physical capacity in the general population , but has been scarcely investigated in patients with chronic kidney disease ( CKD ) . Aims To evaluate the impact of a home-based aerobic training on the cardiopulmonary and functional capacities of overweight non-dialysis-dependent patients with CKD ( NDD-CKD ) . Methods Twenty-nine sedentary patients ( 55.1 ± 11.6 years , BMI = 31.2 ± 6.1 kg/m2 , eGFR = 26.9 ± 17.4 mL/min/1.73 m2 ) were r and omly assigned to a home-based exercise group ( n = 14 ) or to a control group ( n = 15 ) that remained without performing exercise . Aerobic training was performed three times per week for 12 weeks . A cardiopulmonary exercise test , functional capacity and clinical parameters were evaluated . Results A significant increase , ranging from 8.3 to 17 % , was observed in the cardiopulmonary capacity parameters , such as maximal ventilation ( p = 0.005 ) , VO2peak ( p = 0.049 ) , ventilatory threshold ( p = 0.040 ) and respiratory compensation point ( p < 0.001 ) , of the exercise group . A simultaneous improvement in the functional capacity tests [ 6-min walk test ( p < 0.001 ) , time up and go test ( p < 0.001 ) , arm curl test ( p < 0.001 ) , sit and st and test ( p < 0.001 ) , 2-min step test ( p < 0.001 ) and back scratch test ( p = 0.042 ) ] was also found in patients who were su bmi tted to the exercise . Exercised patients experienced a decrease in systolic and diastolic blood pressure , average 10.6 % ( p < 0.001 ) and 9.2 % ( p = 0.007 ) , respectively , and a trend toward improved renal function ( p = 0.1 ) . No change in any parameter was found in the control group during the follow-up . Conclusion The home-based aerobic exercise program was feasible , safe and effective for the improvement in the cardiopulmonary and functional capacities of overweight NDD-CKD patients Background Patients with obesity , diabetes , and chronic kidney disease ( CKD ) are generally physically inactive , have a high mortality rate , and may benefit from an exercise program . Methods We performed a 24-week r and omized controlled feasibility study comparing aerobic exercise plus optimal medical management to medical management alone in patients with type 2 diabetes , obesity ( body mass index [ BMI ] > 30 kg/m2 ) , and stage 2 - 4 CKD ( estimated glomerular filtration rate [ eGFR ] 15 - 90 mL/min/1.73 m2 with persistent proteinuria ) . Subjects r and omized to exercise underwent thrice weekly aerobic training for 6 followed by 18 weeks of supervised home exercise . The primary outcome variable was change in proteinuria . Results Seven subjects r and omized to exercise and 4 control subjects completed the study .  Exercise training result ed in an increase in exercise duration during treadmill testing , which was accompanied by slight but insignificant decreases in resting systolic blood pressure and 24-hour proteinuria . Exercise did not alter GFR , hemoglobin , glycated hemoglobin , serum lipids , or C-reactive protein ( CRP ) . Caloric intake and body weight and composition also did not change with exercise training . Conclusion Exercise training in obese diabetic patients with CKD is feasible and may have clinical benefits . A large-scale r and omized controlled trial to determine the effects of exercise on renal functions , cardiovascular fitness , inflammation , and oxidative stress in diabetic patients with CKD is planned Background : Patients with type 2 diabetes mellitus ( DM ) , obesity , and chronic kidney disease ( CKD ) are generally physically inactive and may benefit from exercise . Our objective was to determine the effects of structured exercise on physical fitness , kidney function , endothelial function , inflammation , and body composition in such patients . Methods : In this r and omized , controlled trial , 36 male patients ( age 49 - 81 ) were r and omly assigned to exercise + diet management ( n = 18 ) or diet alone ( n = 18 ) . Participants were eligible if they had type 2 DM , body mass index > 30 kg/m2 , CKD stages 2 - 4 , and persistent proteinuria ( > 200 mg/g creatinine for > 3 months ) . The exercise intervention was a 12-week ( 3 days per week ) program of aerobic and resistance training followed by 40 
    Output:
    
However , exercise therapy did not significantly affect serum creatinine ( SCr ) , total cholesterol ( TC ) , high density lipoprotein ( HDL ) or low density lipoprotein ( LDL ) in non-dialysis CKD patients .
Conclusion Exercise therapy could benefit non-dialysis CKD patients by increasing eGFR while reducing SBP , DBP and BMI .
Additionally , short-term intervention of exercise could decrease TG