| Summary: | 碩士 === 中國醫藥大學 === 物理治療學系復健科學碩士班 === 99 === Chronic kidney disease (CKD) is a worldwide public health problem. CKD eventually leads to permanent loss of kidney function indicates that patients inevitably suffer from end stage renal disease (ESRD) and require renal replacement therapies such as dialysis and/or transplantation. According to United States Renal Data System (USRDS), the prevalence of ESRD for 2007 was the highest in Taiwan. The incidence and prevalence of CKD rise steadily and cause many public health problems and huge expenditure of National Health Insurance program. CKD may develop some complications such as high blood pressure, anemia, osteodystrophy, poor nutritional health and nerve damage. Also, CKD increases the risk of morbidity and mortality. Death of CKD is commonly caused by cardiovascular disease.
Renal fibrosis is always the ultimate result of CKD. Glomerulosclerosis is a common characteristic in patients with progressive CKD. Fibrosis is caused by a series of events, including: (1) injury to the capillary epithelial/endothelial cells; (2) release of TGF-β1, the major fibrogenic cytokine which has been identified as the main inducer of epithelial mesenchymal transition (EMT) and disruption of the underlying tubular basement membrane (TBM) by MMPs; (3) recruitment of inflammatory cells and cytokine, such as helper T cell, IL-6 and TNF-α; (4) increase in of reactive oxygen species (ROS); and (5) activate collagen production/accumulation .
Regular physical exercise tends to ameliorate a diversity of endothelial functions by preventing the bone loss and minimizing the attack from radical oxygen species, hence it has become a non-pharmacological intervention for treating the metabolic syndrome. Most patients suffering from CKD are inactive and tend to have reduced physical function and performance, and result in poor quality of life, or need dialysis. In this study, CKD was induced in Sprague-Dawley (SD) rats by injection of s.c. 8.5 mg/kg of Doxorubicin (DR) and the beneficial effect of treadmill running exercise was evaluated. SD rats were divided into 3 groups each for control (n=18) and CKD-induced groups (n=24). Among three groups of both control and experimental, one group was not subjected to physical exercise. Second group was subjected to 30 min/day exercise and the third group was subjected to 60 min/day. The speed of the treadmill was 30m/min. The exercises were carried out three times a week for the duration of 3 months. Results showed that regular running significantly decreased levels of cholesterol, triglyceride and increase serum albumin in a dose-responsive manner. In addition, regular running exercise for 60 min significantly decrease the urine protein levels, the oxidative, inflammatory stress and fibrogenesis. In summary, regular running exercise can be an alternative treatment or an adjuvant remedy for treating CKD.
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