Cardiorespiratory fitness and cardiovascular burden in chronic kidney disease. Issue 4 (July 2015)

• Record Type: Journal Article
• Authors: Howden, Erin J.; Weston, Kassia; Leano, Rodel; Sharman, James E.; Marwick, Thomas H.; Isbel, Nicole M.; Coombes, Jeff S.
• Is Part Of: Journal of science and medicine in sport. Volume 18:Issue 4(2015:Jul.)
• Page Start: 492
• Page End: 497
• Publication Date: 2015-07
• Subjects: Sports sciences -- Periodicals; Sports medicine -- Periodicals; Exercise -- Physiological aspects -- Periodicals; Sports -- physiology -- Periodicals; Sports Medicine -- Periodicals; Sportgeneeskunde; 617.102705
• DOI: 10.1016/j.jsams.2014.07.005
• Languages: English
• ISSNs: 1440-2440

Abstract

<abstract abstract-type="author" id="abs0005"> <title id="sect0005">Abstract</title> <sec> <title id="sect0010">Objectives</title> <p id="spar0005">Reduced functional capacity is associated with poor prognosis. In patients with chronic kidney disease the factors that contribute to low cardiorespiratory fitness are unclear. The objective of this study was to evaluate the cardiorespiratory and cardiovascular response to exercise in chronic kidney disease patients, and secondly investigate the relationships between cardiorespiratory fitness and cardiovascular burden.</p> </sec> <sec> <title id="sect1015">Design</title> <p id="spar1010">Cross-sectional analysis.</p> </sec> <sec> <title id="sect0015">Methods</title> <p id="spar0010">Baseline demographic, anthropometric and biochemical data were examined in 136 patients with moderate chronic kidney disease (age 59.7 ± 9.6 yrs, eGFR 40 ± 9 ml/min/1.73 m<sup>2</sup>, 55% male, 39% with a history of cardiovascular disease, 38% diabetic and 17% current smokers). Cardiorespiratory fitness was measured as peak VO<sub>2</sub>, left ventricular morphology and function using echocardiography, central arterial stiffness by aortic pulse wave velocity and left ventricular afterload using augmentation index. Physical activity levels were assessed using the Active Australia questionnaire.</p> </sec> <sec> <title id="sect0020">Results</title> <p id="spar0015">Peak VO<sub>2</sub> (22.9 ± 6.5 ml/kg/min) and peak heart rate (148 ± 22 bpm) were 17% and 12% lower than the age-predicted values, respectively. The low fit group were significantly older, and were more likely to have type II diabetes, cardiovascular disease, a higher BMI and be less active than the high fit group (<italic>P</italic> < 0.05). The independent predictors of peak VO<sub>2</sub> were age, type II diabetes, hemoglobin level, physical activity, aortic pulse wave velocity, augmentation index, and global longitudinal strain.</p> </sec> <sec> <title id="sect0025">Conclusions</title> <p id="spar0020">In patients with chronic kidney disease, the peak VO<sub>2</sub> and heart rate response is markedly impaired. Reduced cardiorespiratory fitness is independently associated with increased aortic stiffness, increased left ventricle afterload, poor left ventricle function and higher burden of cardiovascular risk.</p> </sec> </abstract>