JASN submission revision 3.pdf (2.15 MB)
Download file

Evidence for anti-inflammatory effects of exercise in CKD

Download (2.15 MB)
journal contribution
posted on 2020-11-24, 11:13 authored by Joao Viana, George C. Kosmadakis, Emma L. Watson, Alan Bevington, John Feehally, Nicolette BishopNicolette Bishop, Alice C. Smith
CKD is associated with a complex state of immune dysfunction characterized by immune depression, predisposing patients to infections, and immune activation, resulting in inflammation that associates with higher risk of cardiovascular disease. Physical exercise may enhance immune function and exert antiinflammatory effects, but such effects are unclear in CKD. We investigated the separate effects of acute and regular moderate-intensity aerobic exercise on neutrophil degranulation (elastase release), activation of T lymphocytes (CD69 expression) and monocytes (CD86 and HLA-DR expression), and plasma inflammatory markers (IL-6, IL-10, soluble TNF-receptors, and C-reactive protein) in patients with predialysis CKD. A single 30-minute (acute) bout of walking induced a normal pattern of leukocyte mobilization and had no effect on T-lymphocyte and monocyte activation but improved neutrophil responsiveness to a bacterial challenge in the postexercise period. Furthermore, acute exercise induced a systemic anti-inflammatory environment, evidenced by amarked increase in plasma IL-10 levels (peaked at 1 hour postexercise), that was most likely mediated by increased plasma IL-6 levels (peaked immediately postexercise). Six months of regular walking exercise (30 min/d for 5 times/wk) exerted anti-inflammatory effects (reduction in the ratio of plasma IL-6 to IL-10 levels) and a downregulation of T-lymphocyte and monocyte activation, but it had no effect on circulating immune cell numbers or neutrophil degranulation responses. Renal function, proteinuria, and BP were also unaffected. These findings provide compelling evidence that walking exercise is safe with regard to immune and inflammatory responses and has the potential to be an effective anti-inflammatory therapy in predialysis CKD.



  • Sport, Exercise and Health Sciences

Published in

Journal of the American Society of Nephrology






2121 - 2130


VIANA, J.L. ... et al, 2014. Evidence for anti-inflammatory effects of exercise in CKD. Journal of the American Society of Nephrology, 25 (9), pp.2121-2130.


© American Society of Nephrology


AM (Accepted Manuscript)

Publisher statement

This work is made available according to the conditions of the Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 International (CC BY-NC-ND 4.0) licence. Full details of this licence are available at: https://creativecommons.org/licenses/by-nc-nd/4.0/

Acceptance date


Publication date


Copyright date



This paper was accepted for publication in the serial, Journal of the American Society of Nephrology [© American Society of Nephrology]. The definitive version is available at: http://dx.doi.org/10.1681/ASN.2013070702