Effects of Multimodal Exercise Program Combined with Inspiratory Muscle Training on Cardio-renalmuscle Axis and Clinical Outcomes in a Patient with Chronic Kidney Disease

Abstract

Background: Chronic Kidney Disease (CKD) disrupts the cardio-renal- muscle axis, causing reduced functional capacity, muscle weakness, and poor quality of life. Methods: A 52-year-old male with Stage 3 CKD (eGFR 30-59 mL/min/1.73m²) underwent a 12-week multimodal exercise program with Inspiratory Muscle Training (IMT): aerobic training (40-60% target heart rate), resistance training (60-70% 1RM), box breathing, and IMT (30-60% MIP), thrice weekly, with outcomes assessed at baseline and post-intervention. Results: Following intervention, 6-MWD elevated from 320 to 405 m (+26.6%), Sit-to- Stand repetitions from 10 to 16 (+60.0%), MIP from 55 to 80 cm H₂O (+45.5%), hs-CRP fell from 7.8 to 3.9 mg/L (−50.0%), IL-6 from 10.5 to 5.8 pg/mL (-44.8%), eGFR elevated from 42 to 48 mL/min/1.73m² (+14.3%), serum creatinine (-14.29%) and KDQOL-36 from 50 to 72 (+44.0%). Conclusion: As a single-case design (n=1), results reflect clinical rather than statistical significance. Multimodal exercise combined with IMT safely improved cardio-renal-muscle axis function in Stage 3 CKD.