Neurovascular Regulation During Exercise in Humans With Chronic Kidney Disease: Sympatholysis in CKD
Emory University
Summary
The goals of this project are to investigate the mechanisms and potential therapies related to exercise capacity in persons with chronic kidney disease (CKD).
Description
Patients with chronic renal failure suffer from exercise intolerance and poor physical capacity. Both patients with end-stage renal disease (ESRD) and chronic kidney disease (CKD) not yet on dialysis have significant impairments in measures of exercise capacity including peak work capacity (PWC) and peak oxygen uptake (VO2 peak). The mechanisms underlying exercise intolerance in CKD are multifactorial and not fully understood, and the mechanistic roles of abnormal neurocirculatory and vascular responses during exercise have not been fully elucidated. Such abnormalities have been found to be an…
Eligibility
- Age range
- 40–75 years
- Sex
- All
- Healthy volunteers
- No
Inclusion Criteria: * patients with CKD (Stages III and IV), kidney transplant recipients with varying degrees of kidney function, or persons without kidney disease as matched study controls * sedentary and do not regularly exercise (defined as exercising \< 20 minutes twice per week) * CKD patients must have stable renal function (no greater than a decline of estimated glomerular filtration (eGFR) of 1 cc/min/1.73 m2 per month over the prior 6 months) and baseline serum bicarbonate 22-24 mmol/L * comorbid hypertension Exclusion Criteria: * severe CKD (eGFR\<15 cc/min) * metabolic alkalosis…
Interventions
- DrugSodium Bicarbonate
Participants take 650-1300 mg of sodium bicarbonate orally twice daily. Serum bicarbonate levels are measured at baseline and then every 2-4 weeks throughout the trial. Doses will be adjusted or held to avoid metabolic alkalosis.
- BehavioralExercise Training
Exercise training consists of progressive, interval-based "Spin" exercise on stationary bicycles three times per week for 12 weeks, led by a certified exercise physiologist. The duration of each session begins at 20 minutes and is increased by 1 to 2 minutes as tolerated to a goal of 45 minutes per session. Exercise intensity begins at low levels (50% of maximal heart rate reserve (HRR)) and increases by 5% every week to a goal of 75% maximal HRR. Each session includes a 5-min warm up, then an interval-based, work-out phase that includes steady up-tempo cadences, sprints, and climbs, followed by a 5-minute cool down.
- DrugPlacebo
Participants take placebo pills to match 650-1300 mg of sodium bicarbonate orally twice daily.
Locations (2)
- Emory ClinicAtlanta, Georgia
- Atlanta VA Medical CenterDecatur, Georgia