Implications for practice and research

• ■ There is robust evidence for significant benefits of regular exercise training on physical fitness and function in patients receiving renal replacement therapy (RRT).

• ■ Data support the use of regular exercise to improve cardiovascular health in patients undergoing renal replacement therapy albeit robust data from large scale randomised controlled trials (RCTs) designed to investigate cardiovascular health outcomes are lacking.

• ■ Clinicians should counsel patients with chronic kidney disease (CKD) to increase physical activity levels and inform them that there is scientific evidence that regular exercise benefits health. Potential referral to clinical exercise programs should be considered.

• ■ Future studies should stratify participants based on CKD aetiology and stage, include sufficient sample size, and employ a rigorous RCT design using exercise as an adjunctive …