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06.09.2014
If you have chronic kidney disease (CKD) then your kidneys are not working as well as they once did. Moderate exercise such as walking just twice a week can reduce pain and other symptoms of fibromyalgia without making joints feel worse, according to a new study published in Arthritis Care & Research. While previous studies have shown short term benefits from exercise, fibromyalgia sufferers often fail to keep up with exercise programs out of fear that it will worsen pain. Researchers recruited 170 people for the study who had been diagnosed with fibromyalgia, had been on medication for the condition for at least a month and reported low levels of physical activity. They each received a personalized aerobic exercise program based on their current fitness level, which usually meant walking around a track. Over the next three months, the exercise programs gradually increased in intensity from twice weekly 10-minute sessions to up to four weekly 30-minute sessions of moderate exercise that achieved 60 percent of maximum heart rate.
During the study and six months after it ended, participants reported their activity levels in a questionnaire — assessing how their fibromyalgia symptoms changed, including muscle impairment, overall well-being, pain levels, and depression.
The two groups that exercised reported less physical impairment and better overall well-being than those who did not increase their activity. The study found that any increase in activity, whether or not it was maintained, resulted in positive changes in symptoms and no increase pain. A recent study found that a traditional Chinese meditative exercise significantly reduces pain caused by fibromyalgia in as little as 8 weeks. Fibromyalgia is a poorly understood disorder that is characterized by joint pain, tenderness, fatigue, depression, headaches, irritable bowel and bladder symptoms, depression and lack of sleep. Although the cause of fibromyalgia is unclear, research indicates that it is primarily an amplified disorder of pain perception resulting from neurochemical imbalances in the central nervous system. And researchers believe if they had followed the participants for a longer period of time, they might have seen even more benefits for people who continued to exercise. The routine practice of Qigong also showed sustained benefits in sleep, fatigue, anxiety, physical function and overall well-being.


Severity can vary but most cases are: mild or moderate, occur in older people, do not cause symptoms and do not progress to kidney failure. Treatment is usually based on pain relievers, antidepressants and anti-seizure drugs, along with lifestyle changes and excercise. People with any stage of CKD have an increased risk of developing heart disease or a stroke. This is why it is important to detect even mild CKD, as treatment may not only slow down the progression of the disease, but also reduces the risk of developing heart disease or stroke. This leaflet is for people who have been diagnosed with mild-to-moderate CKD (stage 1, 2 or 3 CKD). A separate leaflet in this series, called Chronic Kidney Disease, is more appropriate if you have more severe CKD (stage 4 or 5 CKD). In the outer part of the kidneys, tiny blood vessels cluster together to form structures called glomeruli. The structure of the glomerulus allows waste products and some water and salt to pass from the blood into a tiny channel called a tubule. The urine then passes down a tube called a ureter which goes from each kidney to the bladder.
The main functions of the kidneys are to: Filter out waste products from the bloodstream, to be passed out in the urine. CKD is a better term, as the word failure implies that the kidneys have totally stopped working. In most people who have CKD there is only a mild or moderate reduction in kidney function, which usually does not cause symptoms, and the kidneys have not failed. If you are found to have CKD then the eGFR test is usually done at regular intervals to monitor your kidney function.
Although about half of people aged 75 or more have some degree of CKD, most of these people do not actually have diseases of their kidneys; they have normal ageing of their kidneys.


However, CKD can also cause high blood pressure, as the kidney has a role in blood pressure regulation.
Also, blood tests may be done from time to time to check on your blood level of chemicals such as sodium, potassium, calcium and phosphate.
The need for other tests then depends on various factors and your doctor will advise - for example: An ultrasound scan of the kidneys or a kidney biopsy may be advised if certain kidney conditions are suspected - for example, if you have a lot of protein or blood in your urine, if you have pain that seems to be coming from a kidney, etc.
In many people, treatment at early stages of CKD can prevent or slow down progression through to eventual kidney failure.
For example, good glucose control for people with diabetes, blood pressure control for people with high blood pressure, etc.
You should have checks every now and then by your GP or practice nurse to monitor your kidney function (eGFR). They will also give you treatment and advice on how to prevent or slow down the progression of CKD. The most important treatment to prevent or delay the progression of CKD, whatever the underlying cause, is to keep your blood pressure well controlled. People with CKD are actually twenty times more likely to die from cardiovascular-related problems than from kidney failure. Briefly, this typically includes: Good control of blood pressure (and blood glucose level if you have diabetes).
A type of medication called an angiotensin-converting enzyme (ACE) inhibitor (for example, captopril, enalapril, ramipril, lisinopril) has been shown to be beneficial for some people with CKD, as it reduces the risk of cardiovascular disease and can prevent further worsening of the function of your kidneys. Note: people with stage 3 CKD or worse should also be immunised against influenza each year, and have a one-off immunisation against pneumococcus.



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