Combined Versus Multicomponent Training in People With Chronic Kidney Disease Stages 3a and 3b

This randomized controlled trial will compare the effects of 12 weeks of combined training (aerobic plus resistance exercise) and multicomponent training (aerobic plus resistance plus balance exercise) with a control group without supervised exercise in adults aged 55 to 70 years with chronic kidney disease (CKD) stages 3a or 3b who are not on dialysis. Fifty-seven participants will be randomly allocated (1:1:1) to one of the three groups. Supervised training sessions will last 60 minutes and will be held three times a week at the University of Brasilia, Brazil. The main questions are whether these programs improve peak oxygen uptake, resting blood pressure, physical health-related quality of life, and estimated glomerular filtration rate, and whether adding balance exercises provides additional benefits for balance, falls, and functional capacity.

Inclusion Criteria: * CKD stage 3a or 3b (eGFR 30-59 mL/min/1.73 m2) according to KDIGO 2024, diagnosed at least 6 months before enrollment * Age between 55 and 70 years * Body mass index between 18.5 and 35 kg/m2 * No participation in a structured exercise program in the previous 3 months * Controlled systemic arterial hypertension and/or type 2 diabetes mellitus are allowed * No clinical contraindication to exercise training or to the study assessments * Literacy sufficient to understand the informed consent form and questionnaires Exclusion Criteria: * CKD stages 1, 2, 4, or 5, dialysis, or kidney transplantation * Polycystic kidney disease * Congestive heart failure, advanced chronic obstructive pulmonary disease, heart disease, arrhythmias, unstable angina, or type 1 diabetes mellitus * Dementia or psychiatric disorders that compromise understanding of instructions or safe exercise * Musculoskeletal injuries or neurological disorders that prevent participation in the exercise program * Concurrent participation in another supervised exercise program