Our results suggest that the beneficial effect of exercise intervention on renal outcomes was reproduced in patients with stage 4 CKD, regardless of the complications of diabetes and obesity, combined with the finding of our previous RCT revealing an improvement in liver-type fatty acid-binding protein, a biomarker of CKD progression,6 in the exercise group.5 Here, FABP1 is linked to obesity due to melanocortin 4 receptor deficiency.