Kidney Week

Abstract: TH-PO0501

β-Blocker Treatment Does Not Alter Peak Oxygen Uptake (VO2 Peak) in Patients Undergoing Hemodialysis

Session Information

• Dialysis: Novel Therapeutics and Medication Management
  November 06, 2025 | Location: Exhibit Hall, Convention Center
  Abstract Time: 10:00 AM - 12:00 PM

Category: Dialysis

• 801 Dialysis: Hemodialysis and Frequent Dialysis

Authors

• Groninger, Nolan, Indiana University School of Medicine, Indianapolis, Indiana, United States

Nolan Groninger, MPH

• Campos, Monique Opuszcka, Indiana University School of Medicine, Indianapolis, Indiana, United States

Monique Opuszcka Campos, PhD

• Narayanan, Gayatri, Indiana University School of Medicine, Indianapolis, Indiana, United States

Gayatri Narayanan, MS

• Lim, Kenneth, Indiana University School of Medicine, Indianapolis, Indiana, United States

Kenneth Lim, MD, PhD, FASN

Group or Team Name

• Lim Lab.

Background

Severely impaired cardiovascular functional capacity (CVC) is a predominant manifestation in patients with heart failure in advanced CKD, where β-blockers (BBs) are a key therapy for this condition and are often continued after hemodialysis (HD) initiation. However, there remain safety concerns on whether BBs could worsen CVC in patients on HD, given that blunting of oxygen uptake at peak exercise (VO₂Peak – gold-standard index for CVC) has been observed in the general heart failure population. Herein, we examined the influence of BB treatment on VO₂Peak in patients on HD.

Methods

We conducted a cross-sectional study of 38 patients on HD who underwent cardiopulmonary exercise testing (CPET) and echocardiography in the ECON and SPARK trials. Patients were stratified into BB (n=20) and non-BB (n=18) groups. Groups were compared using independent t-tests or Chi-squared tests. CPET-derived variables were adjusted by age and sex and reported as adjusted least-square means ± standard error. Multiple regression models were adjusted for the same variables.

Results

The BB and non-BB groups were well-matched with respect to sex, race, BMI, and frequency of hypertension and diabetes diagnoses (all P>0.05). Additionally, dialysis vintage, hemoglobin levels, resting blood pressure and heart rate (HR) were similar between groups (all P>0.05). However, the BB group was significantly younger (47±10 y) than the non-BB group (58±12 y; P=0.002). No differences were observed in left ventricular ejection fraction (BB: 63.3±14.5, non-BB: 62.3±9.6%; P=0.86). Both groups achieved RER>1.0, confirming maximal effort on CPET. Adjusted VO₂Peak was similar between the BB (12.9±0.77 mL/min/kg) and non-BB groups (12.9±0.73 mL/min/kg; P=0.99). Similarly, the adjusted peak HR was not significantly reduced in the BB group (104±4 bpm) compared to the non-BB group (112±4 bpm; P=0.18), and peak workload was comparable between the two groups (P=0.80). Multiple regression demonstrated that BB use showed no association with VO₂Peak (P=0.99) or peak HR (P=0.18).

Conclusion

The study findings demonstrate that CVC (as assessed by VO₂Peak) is not influenced by BB treatment in patients on HD. The findings shed light on the BB safety profile in patients on HD and provide strong rationale for further validation studies, and to evaluate the role of cardioselective versus non-cardioselective BBs.

Funding

• Other NIH Support

Digital Object Identifier (DOI)

• doi: 10.1681/ASN.2025rhc05mxb