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

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Abstract

Background

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.

Methods

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.

Results

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.

Conclusions

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.

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Acknowledgements

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.

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Authors and Affiliations

  1. Graduate School of Sports and Health Science, Fukuoka University, 8-19-1 Nanakuma, Johnan-ku, Fukuoka, 814-0180, Japan

    Kazuko Kotoku

  2. Faculty of Medicine and Health Science, Yamaguchi University, 1-1-1, Minamiogushi, Ube, Yamaguchi, 755-8505, Japan

    Kazuko Kotoku

  3. Division of Nephrology and Rheumatology, Department of Internal Medicine, Fukuoka University School of Medicine, 7-45-1 Nanakuma, Johnan-ku, Fukuoka, 814-0133, Japan

    Tetsuhiko Yasuno & Takao Saito

  4. Department of Rehabilitation, Fukuoka University Chikushi Hospital, 1-1-1 Zokumyoin, Chikushino, Fukuoka, 818-0067, Japan

    Shotaro Kawakami

  5. Department of Rehabilitation, Fukuoka University Hospital, 7-45-1 Nanakuma, Johnan-ku, Fukuoka, 814-0133, Japan

    Kanta Fujimi & Takuro Matsuda

  6. Laboratory of Exercise Physiology, Faculty of Sports and Health Science, Fukuoka University, 8-19-1 Nanakuma, Johnan-ku, Fukuoka, 814-0180, Japan

    Shihoko Nakashima, Yoshinari Uehara, Hiroaki Tanaka & Yasuki Higaki

  7. Fukuoka University Institute for Physical Activity, 8-19-1 Nanakuma, Johnan-ku, Fukuoka, 814-0180, Japan

    Yoshinari Uehara, Hiroaki Tanaka & Yasuki Higaki

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  1. Kazuko Kotoku
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  2. Tetsuhiko Yasuno
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  9. Takao Saito
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  10. Yasuki Higaki
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Correspondence to Yasuki Higaki.

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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.

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

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Kotoku, K., Yasuno, T., Kawakami, S. et al. Effect of exercise intensity on renal blood flow in patients with chronic kidney disease stage 2. Clin Exp Nephrol 23, 621–628 (2019). https://doi.org/10.1007/s10157-018-01685-3

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  • DOI: https://doi.org/10.1007/s10157-018-01685-3

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