Clinical and Experimental Nephrology

, Volume 23, Issue 5, pp 621–628 | Cite as

Effect of exercise intensity on renal blood flow in patients with chronic kidney disease stage 2

  • Kazuko Kotoku
  • Tetsuhiko Yasuno
  • Shotaro Kawakami
  • Kanta Fujimi
  • Takuro Matsuda
  • Shihoko Nakashima
  • Yoshinari Uehara
  • Hiroaki Tanaka
  • Takao Saito
  • Yasuki HigakiEmail author
Original article



Acute exercise reduces renal blood flow (RBF). However, the effect of exercise intensity on RBF in patients with chronic kidney disease (CKD) stage 2 is not known. We investigated the association between RBF and exercise intensity in patients with CKD stage 2 using pulsed Doppler ultrasonography.


Eight men with CKD stage 2 (cystatin C-based estimate of glomerular filtration rate: 60–89 ml/min/1.73 m2) participated in this study. Using a bicycle ergometer, participants undertook a maximal graded exercise test (MGET) (experiment 1) and a multi-stage exercise test (experiment 2) to determine their lactate threshold (LT). Participants undertook a multi-stage exercise test for 4-min each. Workloads of 60%, 80%, 100%, 120%, and 140% of LT were used in experiment 3. RBF was measured by pulsed Doppler ultrasonography at rest, immediately after exercise, and 1 h after exercise in experiment 1, and at rest and immediately after each exercise bout in experiment 3.


Renal blood flow after the MGET was 52% lower than at rest, and did not recover as well as after the exercise test. Cross-sectional area (CSA) was significantly lower after graded exercise. RBF tended to be lower at 100% of LT and was significantly lower at 120% of LT. CSA was significantly lower at 100% of LT.


Renal blood flow does not change during exercise until the LT is reached. These findings may assist in making appropriate exercise recommendations to patients with CKD stage 2.


Exercise intensity Renal blood flow Chronic kidney disease stage 2 



We acknowledge the contribution of the staff at Fukuoka University, who helped with the recruitment of participants and data analyses in our study. We are grateful to the participants in this study. This work was supported by JSPS KAKENHI (15H03082) to Y.H., and Fukuoka University Institute for Physical Activity, Fukuoka, Japan.

Compliance with ethical standards

Conflict of interest

The authors declare that no conflict of interest exists.

Ethical approval

All procedures carried out in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee at which the studies were conducted (Ethics Committee of Fukuoka University approval number 16-4-01) and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards.

Informed consent

Informed consent was obtained from all participants included in the present study.


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Copyright information

© Japanese Society of Nephrology 2019

Authors and Affiliations

  • Kazuko Kotoku
    • 1
    • 2
  • Tetsuhiko Yasuno
    • 3
  • Shotaro Kawakami
    • 4
  • Kanta Fujimi
    • 5
  • Takuro Matsuda
    • 5
  • Shihoko Nakashima
    • 6
  • Yoshinari Uehara
    • 6
    • 7
  • Hiroaki Tanaka
    • 6
    • 7
  • Takao Saito
    • 3
  • Yasuki Higaki
    • 6
    • 7
    Email author
  1. 1.Graduate School of Sports and Health ScienceFukuoka UniversityFukuokaJapan
  2. 2.Faculty of Medicine and Health ScienceYamaguchi UniversityUbeJapan
  3. 3.Division of Nephrology and Rheumatology, Department of Internal MedicineFukuoka University School of MedicineFukuokaJapan
  4. 4.Department of RehabilitationFukuoka University Chikushi HospitalChikushinoJapan
  5. 5.Department of RehabilitationFukuoka University HospitalFukuokaJapan
  6. 6.Laboratory of Exercise Physiology, Faculty of Sports and Health ScienceFukuoka UniversityFukuokaJapan
  7. 7.Fukuoka University Institute for Physical ActivityFukuokaJapan

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