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Background  The prevalence of osteopenia and osteoporosis is higher in patients with chronic kidney disease than that in the general population. Although physical exercise prevents bone loss in hemodialysis (HD) patients, previous studies have not focused on peritoneal dialysis (PD) patients. Therefore, we aimed to evaluate the effects of home-based exercise on bone mineral density (BMD) in patients with PD.    Methods  Stable outpatients undergoing PD were randomly assigned to the intervention group ( n  = 26; male, 20; median age, 66 years) or usual-care group ( n  = 27; male, 21; median age, 64 years). Patients in the intervention group performed home-based exercises (resistance exercise, stretching, and aerobic exercise such as walking) for 6 months, whereas those in the usual-care group performed stretching and their usual physical activity. Based on dual X-ray absorptiometry, the primary outcomes were the BMD data of the lumbar spine and proximal femoral neck. Secondary outcomes included physical function and physical activity. Pre- and post-intervention values were compared.    Results  There was no significant within-group change in the BMD of the lumbar spine, femoral neck, and hip after 6 months of the exercise program. The intervention group had significantly improved 30-s chair-stand test, 6-min walk test, and physical activity results.    Conclusions  Home-based exercises in patients with PD did not improve BMD at any of the sites evaluated. Improvement in physical function and physical activity may reduce the risk of falls in patients with PD.    Trial registration  UMIN Clinical Trials Registry,  UMIN000041678 . Registered September 4, 2020; retrospectively registered.    Supplementary Information  The online version contains supplementary material available at 10.1186/s12882-021-02289-y.

Home-based exercise and bone mineral density in peritoneal dialysis patients: a randomized pilot study