Short-term Aerobic Exercise and Vascular Function in CKD Stage 3: A Randomized Controlled Trial

Background The present study was designed to determine the effect of short-term moderate-intensity exercise training on arterial stiffness in patients with chronic kidney disease (CKD) stage 3. Study Design Randomized controlled trial with a parallel-group design. Setting & Participants Testing and training sessions were performed at Springfield College. 46 (treatment group, n=25; control group, n=21) patients with CKD with diabetes and/or hypertension completed the study. Intervention The aerobic training program consisted of 16 weeks of supervised exercise training at 50%-60% peak oxygen uptake (Vo 2peak ) 3 times per week, while the control group remained sedentary. Identical testing procedures were performed following the 16-week intervention. Outcomes The primary outcome was arterial stiffness. Secondary outcomes were aerobic capacity, various blood parameters (endothelin 1, nitrate/nitrite, and high-sensitivity C-reactive protein), and health-related quality of life. Measurements Arterial stiffness was assessed with aortic pulse wave velocity (PWV), aerobic capacity by Vo 2peak , blood parameters by enzyme-linked immunosorbent assays, and health-related quality of life by the 36-Item Short Form Health Survey (SF-36). Participants attended 4 sessions before being randomly assigned to either the treatment or control group. Participants gave consent during the first session, whereas a graded exercise test with measurement of Vo 2peak was completed during the second session. During sessions 3 and 4, aortic PWV was measured at rest prior to 40 minutes of either moderate-intensity exercise training or seated rest. A venous blood sample was obtained prior to exercise or rest and participants completed the SF-36 questionnaire. Results 16 weeks of training led to an 8.2% increase in Vo 2peak for the treatment group ( P =0.05), but no changes in aortic PWV . Limitations Randomization was not concealed and was violated on one occasion; also, use of an indirect measurement of endothelial function and the short duration of the intervention. Conclusions Short-term moderate-intensity exercise training does not alter arterial stiffness in patients with CKD, but seems to reduce endothelin 1 levels.