Kidney Week

Abstract: FR-PO181

Effect of Exercise Intensity on Autoregulation of GFR in Patients with CKD Stage 2

Session Information

• CKD: Epidemiology, Risk Factors, Prevention - II
  October 26, 2018 | Location: Exhibit Hall, San Diego Convention Center
  Abstract Time: 10:00 AM - 12:00 PM

Category: CKD (Non-Dialysis)

• 1901 CKD (Non-Dialysis): Epidemiology, Risk Factors, and Prevention

Authors

• Koutoku, Kazuko, Fukuoka Univercity, Nanakuma, Johnan-ku, Fukuoka, Japan

Kazuko Koutoku,

• Yasuno, Tetsuhiko, Fukuoka university, Fukuoka, Japan

Tetsuhiko Yasuno,

• Kawakami, Syotaro, Fukuoka University Chikusa Hospital, Fukuoka, Japan

Syotaro Kawakami,

• Fujimi, Kanta, Fukuoka University Hospital, Fukuoka, Japan

Kanta Fujimi,

• Matsuda, Takuro, Fukuoka University Hospital, Fukuoka, Japan

Takuro Matsuda,

• Nakashima, Shihoko, Fukuoka Univercity, Nanakuma, Johnan-ku, Fukuoka, Japan

Shihoko Nakashima,

• Uehara, Yoshinari, Fukuoka University, Fukuoka, Japan

Yoshinari Uehara,

• Saito, Takao, Sanko Clinic, Fukuoka, Japan

Takao Saito,

• Higaki, Yasuki, Fukuoka University, Fukuoka, Japan

Yasuki Higaki,

Background

Several studies have showed that aerobic exercise improves cardiovascular function in patients with CKD. On the other hand, glomerular filtration rate (GFR) significantly decreased during severe exercise in healthy young men (Kawakami S, et al. 2018). The purpose of this study was to determine the association of GFR with intensity of exercise in patients with CKD stage 2.

Methods

Renal blood flow (RBF) was assessed by Duplex ultrasound. GFR was estimated by serum cystatin-C (eGFRcys). FF was calculated with eGFRcys/RBF (1-hemtocrit). Eight males with CKD stage 2 (eGFRcys: 60-89/min/1.73m²) participated in the study, consisting of three separate trials using a cycle ergometer. The first is a maximal graded exercise test. The second is a multi-stage exercise test to determine their lactate threshold (LT). The third is a multi-stage exercise test (4 minutes/stage) at intensities of 60%, 80%, 100%, 120%, and 140% of LT.

Results

eGFRcys significantly decreased and FF significantly increased (eGFRcys: 73±14min/1.73m², FF: 0.44±0.17) after strenuous exercise (p< 0.01). eGFRcys did not decrease until 100% of LT was attained, and showed slight reduction at 120% of LT and 140% of LT (eGFRcys: 76±10min/1.73m² and 72±9min/1.73m²) relative to its resting value. FF was significantly higher at 100% of LT (FF: 0.46±0.16), compared to its resting value (p< 0.01). Heart rate (HR) and the norepinephrine level (NE) also increased with the intensities of LT (HR: p< 0.01, NE: p< 0.05).
(Fig. 1)

Conclusion

Our results demonstrate that GFR does not change during exercise until the LT is attained, although FF increases. These findings suggest that patients with CKD stage 2 might be able to maintain their GFR during exercise up to 100% of LT.