Physical Exercise to Prevent Mild-cognitive Impairment in Patients With Kidney Disfunctions

NCT ID: NCT07160959

Last Updated: 2025-09-08

Study Results

Results pending

The study team has not published outcome measurements, participant flow, or safety data for this trial yet. Check back later for updates.

Basic Information

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Recruitment Status

NOT_YET_RECRUITING

Clinical Phase

NA

Total Enrollment

124 participants

Study Classification

INTERVENTIONAL

Study Start Date

2026-01-01

Study Completion Date

2030-04-30

Brief Summary

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This research project focuses on improving memory and thinking (cognitive function) in people with advanced chronic kidney disease (CKD), a condition that affects about 10% of adults and is often linked to cognitive problems. The study includes a clinical trial where patients will either receive standard care or follow a home-based exercise program involving walking and strength training, to see if regular physical activity can improve brain function. It also includes a large-scale analysis of data from the UK Biobank to explore blood and genetic markers, brain imaging, and lifestyle factors linked to cognitive health. The ultimate aim is to find effective, easy-to-implement strategies and early warning signs that could lead to better treatment and quality of life for people living with CKD.

Detailed Description

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The project aims to test the impact of exercise programs on cognitive function in stage G 4-5 CKD and dialysis patients with MCI in a randomised clinical trial. A structured physical exercise program (walking exercise) effectively improved physical performance and quality of life in dialysis patients in a previous trial by us (see reference 6 by the investigators of this proposal). We will combine resistance and walking exercise in the active arm of the trial. In parallel with this trial, the project aims to test the cross-sectional and longitudinal relationship between physical activity (PAA) and the genetic and circulatory biomarkers of cognitive function and brain MRI in CKD patients and individuals without CKD in the UK Biobank.

Randomised clinical trial This trial will test a structured combined physical exercise program based on home-based aerobic (walking) exercise and resistance exercise maintained for 26 weeks on cognitive function in predialysis patients with advanced CKD (stages 4-5) and dialysis patients with MCI compared to the usual care (control group). In the two study arms, nutritional guidelines by KDIGO will be implemented, and nutrient intake will be periodically assessed. For this purpose, an App for CKD patients, including dietary advice and registering nutrients, will be adapted to the languages of centres in participating countries. Furthermore, body composition will be assessed during the study visits using validated bio-impedance spectroscopy instruments. Two-thirds of enrolees will be predialysis CKD patients and one-third dialysis patients (haemodialysis or peritoneal dialysis patients). Partners or caregivers to assist patients in the trial's exercise arm are requested explicitly for inclusion.

Conditions

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Chronic Kidney Disease (Stages 4 and 5) Mild Cognitive Impairment (MCI)

Study Design

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Allocation Method

RANDOMIZED

Intervention Model

PARALLEL

Primary Study Purpose

PREVENTION

Blinding Strategy

NONE

Study Groups

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Experimental Arm

Combined aerobic (walking) and resistance exercise group. Patients randomised to this group will receive a structured exercise program to be performed at least thrice a week for 26 weeks. The physical exercise intervention will be managed and supervised by the personnel of the centres participating in the trial. The training program will be personalised according to the patient's baseline functional capacity assessed by the 6-minute walking test (6MWT). The aerobic exercise will include seven bouts of 2-minute walking separated by 1-minute seated rest (up to 2-minute periods of resting in the Very Low category) at a slow to moderate speed. A smartphone application designed to guide the weekly increase in speed will also record the number of training sessions performed. An instructor will specifically instruct all patients to walk in rhythm with the metronome. The goal intensity for each session is 9-10 (light-fairly light) on the 20-point Borg RPE. The number of steps per session will

Group Type EXPERIMENTAL

Exercise

Intervention Type BEHAVIORAL

Patients will undergo a home-based low-intensity interval multi component exercise program including aerobic and strengthening exercise

Placebo comparator

The control group will undergo standard nephrology care that include optimization of medical therapy, nutritional advices, best dialysis practice.

Group Type PLACEBO_COMPARATOR

Control (Standard treatment)

Intervention Type OTHER

Patients will be treated with standard therapy based on their CKD stage

Interventions

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Exercise

Patients will undergo a home-based low-intensity interval multi component exercise program including aerobic and strengthening exercise

Intervention Type BEHAVIORAL

Control (Standard treatment)

Patients will be treated with standard therapy based on their CKD stage

Intervention Type OTHER

Eligibility Criteria

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Inclusion Criteria

* CKD at KDOQI stage 4-5
* concomitant MCI (MOCA - MMSE (17 \< MoCA \< 26) or (16 \< MMSE \< 24)

Exclusion Criteria

* Absolute contraindication to exercise training (e.g. unstable angina, major amputation, severe heart failure, etc.)
* Known life expectancy \< 6-month
* Uncorrected anemia (Hb \<9 g/dl)
* Non-provision of informed consent
Minimum Eligible Age

18 Years

Eligible Sex

ALL

Accepts Healthy Volunteers

No

Sponsors

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Biogem s.c.ar.l.

OTHER

Sponsor Role lead

Responsible Party

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Responsibility Role SPONSOR

Locations

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Assistance Publique - Hôpitaux de Paris (AP-HP), Division of Geriatry

Paris, , France

Site Status

Biogem

Ariano Irpino, , Italy

Site Status

Lithuanian University of Health Sciences

Kaunas, , Lithuania

Site Status

University Medical Center Groningen, Department of Nephrology

Groningen, , Netherlands

Site Status

Medical University of Warsaw, Department of Nephrology, Dialysis and Internal Medicine

Warsaw, , Poland

Site Status

University of Zurich

Zurich, , Switzerland

Site Status

Countries

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France Italy Lithuania Netherlands Poland Switzerland

Central Contacts

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Crmine Zoccali

Role: CONTACT

+393407354062

Facility Contacts

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Marion Pépin

Role: primary

+33699426061

Carminre Zoccali

Role: primary

+393407354062

Inga Bumblyte

Role: primary

+37037326189

Casper F.M. Franssen

Role: primary

+31631673051

Jolanta Malyszko

Role: primary

+48225992660

Carsten A. Wagner

Role: primary

+41763770238

Other Identifiers

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ERA4HEALTH2024-NUTRIBRAIN

Identifier Type: OTHER_GRANT

Identifier Source: secondary_id

ERA4HEALTHNUTRIBRAIN-086

Identifier Type: -

Identifier Source: org_study_id

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