Exercise Capacity in Polycystic Kidney Disease

Reinecke, Natália Lopes; Cunha, Thúlio Marquez; Heilberg, Ita Pfeferman; Higa, Elisa Mieko Suemitsu; Nishiura, José Luiz; Neder, J. Alberto; Almeida, Waldemar S.; Schor, Nestor

doi:10.1053/j.ajkd.2014.03.014

Cited by 16 publications

(17 citation statements)

References 35 publications

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“…On the other hand, it is possible that the anti-hypertensive treatment with ARB and/or ACEi by 72% of our patients could have contributed to the lack of association between vitamin D and BP. However, even under anti-hypertensive therapy, 31/70 (44%) of patients from the current series presented a non-dipping pattern, in accordance with several investigators (19, 37, 38), who have detected it even in otherwise normotensive ADPKD subjects (38), as an early manifestation of endothelial dysfunction (39). We observed a high percentage of albuminuria (48%), particularly among hypertensive patients, corroborating with data from Chapman et al (40), but without association with hypovitaminosis D. The use of ARB and/or ACEi might have also accounted for by the absence of such association.…”

Section: Discussionsupporting

confidence: 91%

Association of Vitamin D Levels With Kidney Volume in Autosomal Dominant Polycystic Kidney Disease (ADPKD)

et al. 2019

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Vitamin D possesses renoprotective effects beyond mineral metabolism, potentially reducing arterial blood pressure and inflammation and vitamin D enzymes (CYP24A1 and CYP27B1) as well as vitamin D receptor (VDR) contribute to its homeostasis. In the present study, we aimed to determine vitamin D association with kidney volume, blood pressure parameters and inflammatory markers in ADPKD. This cross-sectional study, conducted from August 2011 through May 2016, evaluated 25(OH)D, 1,25(OH)2D and other hormonal/biochemical serum and urinary parameters, inflammatory markers and monocyte expression of VDR, CYP24A1, CYP27B1 in 74 ADPKD patients. The height-adjusted total kidney volume (htTKV) was determined by MRI and blood pressure (BP) measured through 24-h ambulatory BP monitoring (ABPM).Vitamin D insufficiency was present in 62% of patients and CYP24A1 was overexpressed in this group, raising a hypothesis of 25(OH)D increased catabolism. Serum 25(OH)D levels and VDR expression were negatively correlated with htTKV as was VDR with IL-6, IL-10, CRP, and NFκB. A multiple linear regression analysis with htTKV as dependent variable, including hypertension, CRP, eGFR, age, time since diagnosis, VDR, and 25(OH)D adjusted for season of the year showed that only the first three parameters were independent predictors of the former. There has been no association of serum 25(OH)D and VDR expression with ABPM parameters. Present findings suggested that low levels of serum 25(OH)D and VDR expression are associated with a higher kidney volume in ADPKD patients, but do not represent independent risk factors for htTKV.

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Section: Discussionsupporting

confidence: 91%

Association of Vitamin D Levels With Kidney Volume in Autosomal Dominant Polycystic Kidney Disease (ADPKD)

et al. 2019

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“…In another study, a negative correlation was detected between NO and ADMA after exercise in the early phase of normotensive ADPKD and this was thought to be related to ED (29). The ADMA levels were lower in the patient population compared to the control group in the current study.…”

Section: Discussionsupporting

confidence: 47%

Relationship of Serum Asymmetric Dimethylarginine Levels with Inflammation and Cardiac Functions in Autosomal Dominant Polycystic Kidney Disease

Doğan¹,

Altuner²,

Kahvecioğlu³

et al. 2018

Turk Neph Dial Transpl

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OBJECTIVE: Most deaths in autosomal dominant polycystic kidney disease (ADPKD) are attributable to cardiovascular disease (CVD). The relationship between serum asymmetric dimethylarginine (ADMA) and CVD has been investigated. We aimed to search the relationship between serum ADMA, atherosclerosis, inflammation and cardiac functions in ADPKD. MATERIAL and METHODS:Fifty-seven ADPKD patients and 23 healthy control subjects were enrolled. Carotid artery intima-media thickness (CIMT) and echocardiographic measurements were performed. ADMA, inflammatory markers, Neutrophil Count/Lymphocyte Count (NLR), echocardiographic findings and CIMT values were compared between the groups. Correlation analyses were performed.

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“…Impaired physical capacity in young patients with ADPKD could be explained by underlying endothelial dysfunction, which could depend on inadequate response of nitric oxide, asymmetric dimethylarginine, and BP to acute exercise [36, 61]. Several studies have identified V’E/V’CO 2 , anaerobic threshold, and V’O 2max as prognostic factors in cardiovascular diseases [62-63]. We found, also, a significant increase of cTnT in ADPKD patients, a sensitive and specific marker of ischemic myocardial damage, renally cleared, and widely used as a predictor of cardiovascular events [53].…”

Section: Discussionmentioning

confidence: 99%

Early Markers of Cardiovascular Risk in Autosomal Dominant Polycystic Kidney Disease

Lai

Mastroluca

Matino

et al. 2017

Kidney Blood Press Res

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Background/Aims: Cardiovascular disease is the most frequent cause of morbidity and mortality in autosomal dominant polycystic kidney disease (ADPKD) patients, often before the onset of renal failure, and the pathogenetic mechanism is not yet well elucidated. The aim of the study was to identify early and noninvasive markers of cardiovascular risk in young ADPKD patients, in the early stages of disease. Methods: A total of 26 patients with ADPKD and 24 control group, matched for age and sex, were enrolled, and we have assessed inflammatory indexes, mineral metabolism, metabolic state and markers of atherosclerosis and endothelial dysfunction (carotid intima media thickness (IMT), ankle brachial index (ABI), flow mediated dilation (FMD), renal resistive index (RRI), left ventricular mass index (LVMI)) and cardiopulmonary exercise testing (CPET), maximal O₂ uptake (V’O₂max), and O₂ uptake at lactic acid threshold (V’O₂@LT). Results: The ADPKD patients compared to control group, showed a significant higher mean value of LVMI, RRI, homocysteine (Hcy), Homeostasis Model Assessment-insulin resistance (HOMA-IR), serum uric acid (SUA), Cardiac-troponinT (cTnT) and intact parathyroid hormone (iPTH) (p<0.001, p<0.001, p<0.001, p<0.001, p<0.001, p=0.007, p=0.019; respectively), and a lower value of FMD and 25-hydroxyvitaminD (25-OH-VitD) (p<0.001, p<0.001) with reduced parameters of exercise tolerance, as V’O₂max, V’O₂max/Kg and V’O₂max (% predicted) (p<0.001, p<0.001, p=0.018; respectively), and metabolic response indexes (V’O₂@LT, V’O₂ @LT%, V’O₂@LT/Kg,) (p<0.001, p=0.14, p<0.001; respectively). Moreover, inflammatory indexes were significantly higher in ADPKD patients, and we found a positive correlation between HOMA-IR and C-reactive protein (CRP) (r=0.507, p=0.008), and a negative correlation between HOMA-IR and 25-OH-VitD (r=-0.585, p=0.002). Conclusion: In our study, ADPKD patients, in the early stages of disease, showed a greater insulin resistance, endothelial dysfunction, inflammation and mineral metabolism disorders, respect to control group. Moreover, these patients presented reduced tolerance to stress, and decreased anaerobic threshold to CPET. Our results indicate a major and early cardiovascular risk in ADPKD patients. Therefore early and noninvasive markers of cardiovascular risk and CPET should be carried out, in ADPKD patients, in the early stages of disease, despite the cost implication.

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Exercise Capacity in Polycystic Kidney Disease

Cited by 16 publications

References 35 publications

Association of Vitamin D Levels With Kidney Volume in Autosomal Dominant Polycystic Kidney Disease (ADPKD)

Association of Vitamin D Levels With Kidney Volume in Autosomal Dominant Polycystic Kidney Disease (ADPKD)

Relationship of Serum Asymmetric Dimethylarginine Levels with Inflammation and Cardiac Functions in Autosomal Dominant Polycystic Kidney Disease

Early Markers of Cardiovascular Risk in Autosomal Dominant Polycystic Kidney Disease

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