The relationship between physical activity and blood lipids and lipoproteins in dialysis patients is reviewed in the context of the potentially confounding factors such as nutritional intake, cigarette smoking, obesity, alcohol intake, and physical activity levels in the general population and additional confounding factors such as mode of dialysis and diabetes in dialysis patients. The known associations in the general population of physical activity with high-density-lipoprotein cholesterol subfractions and apolipoprotein A-I are more pronounced in hemodialysis patients than in peritoneal dialysis patients even after adjusting for these confounding factors. Examining studies on the effects of physical activity on blood lipids and lipoproteins, the most consistent observation is the noted decrease in triglycerides and increase in high-density-lipoprotein cholesterol and insulin sensitivity in hemodialysis patients. The changes in lipids and lipoproteins in hemodialysis patients could be caused by changes in activity levels of lipoprotein lipase, insulin sensitivity, and/or glucose metabolism. Future research investigating the relationship between physical activity and blood lipids and lipoproteins in dialysis patients should direct research towards the underlying mechanisms for changes in blood lipids and lipoproteins. 1. Introduction Atherosclerotic heart disease is the leading cause of mortality among patients with chronic kidney disease [1–3]. Chronic kidney disease is associated with dyslipidemia, which seems to persist as renal failure advances and continues to affect clinical outcomes in patients on hemodialysis (HD) and peritoneal dialysis (PD) [4–13]. Patients on HD and PD are at increased risk for atherosclerotic heart disease, which is due at least in part to atherogenic lipid and lipoprotein abnormalities [1]. One study [14] compared traditional atherosclerotic heart disease risk factors among new dialysis patients with those in the general population and reported that the dialysis patients had a high prevalence of diabetes, hypertension, low physical activity, low high-density-lipoprotein cholesterol (HDL-C), and high triglycerides (TG). Exercise capacity as measured by maximal oxygen uptake in HD and PD patients is lower than in sedentary normal controls [15], but dialysis patients regardless of the treatment mode could benefit from appropriate exercise training in order to increase physical working capacity [16–18]. The positive association of physical activity with HDL-C has been reported in the general population [19–21]. Although a
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