The purpose of this study is to investigate the effects of 12 weeks of aerobic exercise training on blood vessel function in Stages 1-4 Chronic Kidney Disease.
The endothelium lines the inside of the blood vessels. A healthy endothelial lining acts as a defense mechanism against vascular injury, mediating vascular tone, vascular structure, and blood-vessel wall relations. Endothelial dysfunction marks the occurrence of cardiovascular injuries and is a critical step in the development of cardiovascular disease. Individuals with Chronic Kidney Disease (CKD) have an increased risk of cardiovascular disease and this may be related to poor blood vessel function. Interventions to improve blood vessel function in CKD are needed. Exercise training has been shown to improve blood vessel function in older subjects and those with heart disease but this has not been investigated in CKD. The National Kidney Foundation recommends exercise for dialysis patients to reduce cardiovascular risk however there is very little data regarding the benefits of exercise in earlier stages of CKD. The purpose of this study is to determine the effect of 12 weeks of exercise training on blood vessel function in moderate to severe CKD.
Study Type
INTERVENTIONAL
Allocation
RANDOMIZED
Purpose
BASIC_SCIENCE
Masking
SINGLE
Enrollment
76
Supervised outpatient moderate to vigorous aerobic training at 60% - 85% heart rate reserve, carried out for 45 minutes, three times per week over a twelve week period.
Department of Kinesiology and Applied Physiology, University of Delaware
Newark, Delaware, United States
Endothelial Function
Conduit artery endothelial function assessed by brachial artery flow mediated dilation; Microvascular endothelial function assessed by cutaneous vasodilation in response to local heating measured by microdialysis and laser Doppler flowmetry.
Time frame: Change from baseline at 12 weeks
Microvascular function
Nitric oxide contribution to cutaneous microvascular vasodilation in response to local heating assessed by microdialysis and laser Doppler flowmetry
Time frame: Change from baseline at 12 weeks
Oxidative stress contribution to vascular dysfunction
Oxidative stress contribution to cutaneous vasodilation dysfunction in response to local heating assessed by microdialysis and laser Doppler flowmetry.
Time frame: Change from baseline at 12 weeks
Endothelial cell oxidative stress
Endothelial cell nitrotyrosine, NADPH oxidase, MnSOD oxidase content obtained from antecubital vein endothelial cells and assessed by fluorescence microscopy.
Time frame: Changes from baseline at 12 weeks
Plasma Oxidized Low Density Lipoprotein
Plasma oxidized low density lipoprotein measured by ELISA
Time frame: Change from baseline at 12 weeks
F2-isoprostanes
Urinary F2-isoprostanes measured by ELISA
Time frame: Change from baseline at 12 weeks
Pulse Wave Analysis
Central blood pressure and augmentation index assessed by oscillometry and radial tonometry
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Time frame: Change from baseline at 12 weeks
Arterial Stiffness
Carotid to femoral pulse wave velocity and assessed by tonometry
Time frame: Change from baseline at 12 weeks
Ambulatory Blood Pressure
24 hour blood pressure recorded by oscillometric monitors
Time frame: Change from baseline at 12 weeks
Peak Aerobic Capacity
Peak oxygen uptake (VO2peak/max) during incremental cycling exercise until exhaustion
Time frame: Change from baseline at 12 weeks
Physical Function
Dexterity by the '9-Hole Peg Test'; Endurance by the '2 Minute Walk Endurance Test'; locomotion by the '4 Meter Gait Speed Test'; isometric handgrip strength test by handgrip dynamometry.
Time frame: Change from baseline at 12 weeks
Habitual Physical Activity
Daily average energy expenditure, step count and physical activity intensity level by accelerometry.
Time frame: Change from baseline at 12 weeks
Knee Extensor Strength
Maximal isometric knee extensor strength
Time frame: Change from baseline at 12 weeks