Exercise training improves HR responses and V˙O2peak in predialysis kidney patients.

HEADLEY, S., M. GERMAIN, C. MILCH, L. PESCATELLO, M. A. COUGHLIN, B. C. NINDL, A. CORNELIUS, S. SULLIVAN, S. GREGORY, and R. WOOD. Exercise Training Improves HR Responses and (V) over dotO(2peak) in Predialysis Kidney Patients. Med. Sci. Sports Exerc., Vol. 44, No. 12, pp. 2392-2399, 2012. Purpose: The current pilot and feasibility study was designed to examine the effect of 48 wk of moderate-intensity exercise training and dietary modification on kidney function and vascular parameters in chronic kidney disease (CKD) patients. Methods: Twenty-one stage 2-4 CKD patients (age, 18-70 yr) were randomly assigned to either the training group (TG, n = 10) or the usual care group (n = 11) for 48 wk. The TG received 48 wk of personal training (3 d.wk(-1) for up to 55 min per session at 50%-60% (V) over dotO(2peak)) and dietary counseling, whereas individuals in the usual care group received standard of care and were instructed not to start a structured exercise program while in the study. (V) over dotO(2peak), estimated glomerular filtration rate (eGFR), resting and ambulatory HR, plasma lipids (total cholesterol, LDL cholesterol, HDL cholesterol, and triglycerides), and inflammatory markers (high-sensitivity C-reactive protein and interleukin 6) were assessed at baseline and weeks 24 and 48. An independent group's t-test was used to compare glomerular filtration rate slopes between groups, whereas all other data were analyzed with ANCOVA using the baseline value as the covariate. Results: There were no statistically significant differences in any of the parameters at baseline. The 48-wk intervention led to a significant increase in (V) over dotO(2peak), reductions in both resting and ambulatory HR, and increases in LDL cholesterol and in TG, but it had no effect on the rate of change of eGFR over time. Conclusions: A 48-wk exercise training program, primarily focused on aerobic exercise, increases (V) over dotO(2peak) and favorably alters autonomic function as evidenced by reductions in HR in stages 2-4 CKD patients. The exercise intervention had no effect on kidney function as assessed by eGFR.