Effect of exercise intensity on renal blood flow in patients with chronic kidney disease stage 2
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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.
KeywordsExercise 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.
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 was obtained from all participants included in the present study.
- 1.Imai E, Horio M, Iseki K, Yamagata K, Watanabe T, Hara S, Ura N, Kiyohara Y, Hirakata H, Moriyama T, Ando Y, Nitta K, Inaguma D, Narita I, Iso H, Wakai K, Yasuda Y, Tsukamoto Y, Ito S, Makino H, Hishida A, Matsuo S. Prevalence of chronic kidney disease (CKD) in the Japanese general population predicted by the MDRD equation modified by a Japanese coefficient. Clin Exp Nephrol. 2007;11:156–163.CrossRefPubMedGoogle Scholar
- 9.Castenfors J. Renal function during exercise. Acta Physiol Scand. 1967;70(Suppl. 293):1–44.Google Scholar
- 13.Kawakami S, Yasuno T, Matsuda T, Fujimi K, Ito A, Yoshimura S, Uehara Y, Tanaka H, Saito T, Higaki Y. Association between exercise intensity and renal blood flow evaluated using ultrasound echo. Clin Exp Nephrol. 2018. https://doi.org/10.1007/s10157-018-1559-1 (Epub ahead of print).CrossRefPubMedGoogle Scholar
- 20.Lesley AS, Josef C, Christopher HS, Harold IF, Marc F, John K, Jerome R, Frederick VL, Robert DB, Yaping Z, Tom G, Andrew SL. Estimating GFR using serum cystatin C alone and in combination with serum creatinine: a pooled analysis of 3418 individuals with CKD. Am J Kidney Dis. 2008;51(3):395–406.CrossRefGoogle Scholar
- 23.Suzuki M. Exercise and renal function. Adv Ex Sports Physiol. 1996;2:45–56.Google Scholar