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Background <p>Physical activity (PA) and exercise are key in the non-pharmacological management of chronic kidney disease (CKD). However, patient awareness, information sources, and adherence to advice are not well-established. Herein, we quantified the awareness of the importance of PA and exercise, identified information sources, described receipt of advice and adherence, and explored factors associated with poor adherence.</p> Methods <p>We conducted a web-based survey of adults with predialysis CKD in Japan. Inclusion criteria included being of age ≥50 years, physician-diagnosed CKD, no prior/active receipt of dialysis or transplant, ability to report recent serum creatinine or estimated glomerular filtration rates, and independence in activities of daily living. Questionnaires assessed awareness of importance (four-level scale), information sources, receipt of advice from healthcare professionals (yes/no), and adherence among recipients. Frailty was measured using the Kihon Checklist. Among recipients of exercise advice, correlates of poor adherence were examined using a modified Poisson regression with robust variance.</p> Results <p>Of the 312 respondents, 285 met the inclusion criteria. Awareness of the importance of PA/exercise was very or moderately evident in 72.7% of respondents, and diet awareness was similarly evident in 85.3%. Physicians (70.1%) and online articles (33.3%) were the most common information sources; physical therapists were rarely cited (4.4%). Overall, 71.6% of respondents reported receiving PA/exercise advice: 12.3% almost completely adhered, 51.0% mostly adhered, 31.9% did not adhere adequately, and 4.9% were unsure how to follow the advice. Frailty was independently associated with poor adherence.</p> Conclusions <p>In predialysis CKD, awareness of exercise lags behind that of diet, information sources are physician-centered, and adherence to advice is often suboptimal, particularly in patients with frailty. These findings reveal a gap in implementation and underscore the need to standardize structured clinical advice and monitoring, integrate exercise professionals into kidney care teams, and provide tailored support for frail patients.</p>

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Awareness of exercise importance, information sources, and adherence in predialysis chronic kidney disease in Japan: a web-based cross-sectional study

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  • 发表日期：

    2026年2月26日

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  • Yuhei Otobe,
  • Connie M. Rhee

摘要

Background

Physical activity (PA) and exercise are key in the non-pharmacological management of chronic kidney disease (CKD). However, patient awareness, information sources, and adherence to advice are not well-established. Herein, we quantified the awareness of the importance of PA and exercise, identified information sources, described receipt of advice and adherence, and explored factors associated with poor adherence.

Methods

We conducted a web-based survey of adults with predialysis CKD in Japan. Inclusion criteria included being of age ≥50 years, physician-diagnosed CKD, no prior/active receipt of dialysis or transplant, ability to report recent serum creatinine or estimated glomerular filtration rates, and independence in activities of daily living. Questionnaires assessed awareness of importance (four-level scale), information sources, receipt of advice from healthcare professionals (yes/no), and adherence among recipients. Frailty was measured using the Kihon Checklist. Among recipients of exercise advice, correlates of poor adherence were examined using a modified Poisson regression with robust variance.

Results

Of the 312 respondents, 285 met the inclusion criteria. Awareness of the importance of PA/exercise was very or moderately evident in 72.7% of respondents, and diet awareness was similarly evident in 85.3%. Physicians (70.1%) and online articles (33.3%) were the most common information sources; physical therapists were rarely cited (4.4%). Overall, 71.6% of respondents reported receiving PA/exercise advice: 12.3% almost completely adhered, 51.0% mostly adhered, 31.9% did not adhere adequately, and 4.9% were unsure how to follow the advice. Frailty was independently associated with poor adherence.

Conclusions

In predialysis CKD, awareness of exercise lags behind that of diet, information sources are physician-centered, and adherence to advice is often suboptimal, particularly in patients with frailty. These findings reveal a gap in implementation and underscore the need to standardize structured clinical advice and monitoring, integrate exercise professionals into kidney care teams, and provide tailored support for frail patients.