A randomized trial of aerobic exercise in chronic kidney disease: Evidence for blunted cardiopulmonary adaptations

Kirkman, Danielle L.; Ramick, Meghan G.; Muth, Bryce J.; Stock, Joseph M.; Townsend, Raymond R.; Edwards, David G.

doi:10.1016/j.rehab.2020.101469

Cited by 11 publications

(7 citation statements)

References 31 publications

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“…Beverly et al also identified that emergency surgery and chronic kidney disease were associated with a high incidence of reintubation after cardiac surgery (14). Patients with chronic kidney disease appeared to have attenuated cardiopulmonary adaptations, which might reflect the affected respiratory muscle strength (15). In addition, kidney disease-related exercise intolerance could lead to increased frailty and worsened quality of life, while the frailty among patients who received mechanical ventilation was related to the need for tracheostomy (16,17).…”

Section: Discussionmentioning

confidence: 99%

A Predictive Scoring Model for Postoperative Tracheostomy in Patients Who Underwent Cardiac Surgery

Wang

et al. 2022

Front. Cardiovasc. Med.

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BackgroundA subset of patients require a tracheostomy as respiratory support in a severe state after cardiac surgery. There are limited data to assess the predictors for requiring postoperative tracheostomy (POT) in cardiac surgical patients.MethodsThe records of adult patients who underwent cardiac surgery from 2016 to 2019 at our institution were reviewed. Univariable analysis was used to assess the possible risk factors for POT. Then multivariable logistic regression analysis was performed to identify independent predictors. A predictive scoring model was established with predictor assigned scores derived from each regression coefficient divided by the smallest one. The area under the receiver operating characteristic curve and the Hosmer-Lemeshow goodness-of-fit test were used to evaluate the discrimination and calibration of the risk score, respectively.ResultsA total of 5,323 cardiac surgical patients were included, with 128 (2.4%) patients treated with tracheostomy after cardiac surgery. Patients with POT had a higher frequency of readmission to the intensive care unit (ICU), longer stay, and higher mortality (p < 0.001). Mixed valve surgery and coronary artery bypass grafting (CABG), aortic surgery, renal insufficiency, diabetes mellitus, chronic obstructive pulmonary disease (COPD), pulmonary edema, age >60 years, and emergent surgery were independent predictors. A 9-point risk score was generated based on the multivariable model, showing good discrimination [the concordance index (c-index): 0.837] and was well-calibrated.ConclusionsWe established and verified a predictive scoring model for POT in patients who underwent cardiac surgery. The scoring model was conducive to risk stratification and may provide meaningful information for clinical decision-making.

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Section: Discussionmentioning

confidence: 99%

A Predictive Scoring Model for Postoperative Tracheostomy in Patients Who Underwent Cardiac Surgery

Wang

et al. 2022

Front. Cardiovasc. Med.

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“…The characteristics of the included studies are outlined in Table 2 , Table 3 , Table 4 , Table 5 . 15 , 16 , 17 , 18 , 19 , 20 , 21 , 22 , 23 , 24 , 25 , 26 , 27 , 28 , 29 , 30 , 31 , 32 , 33 , 34 , 35 , 36 , 37 , 38 , 39 , 40 , 41 , 42 , 43 , 44 , 45 , 46 , 47 , 48 , 49 , 50 , 51 , 52 , 53 , 54 , 55 , 56 , 57 , 58 , 59 , 60 , 61 , 62 , 63 , 64 , 65 , 66 , 67 , 68 , 69 , 70 , 71 , 72 , 73 , 74 , 75 , 76 , 77 , 78 , 79 ,…”

Section: Resultsunclassified

Lifestyle Interventions, Kidney Disease Progression, and Quality of Life: A Systematic Review and Meta-analysis

Neale¹,

Rosario²,

Probst³

et al. 2023

Kidney Medicine

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“…Aerobic exercise recommendations for people with CKD are presented in Table 2 [25,30]. Available data suggests aerobic exercise improves VO 2peak in patients with CKD, ESKD, and kidney transplant recipients [61,79,[86][87][88][89][90][91][92][93][94][95]. The magnitude of aerobic exercise-induced improvement in VO 2peak is estimated to be ≈2 mL•kg −1 •min −1 [79,87,88,96].…”

Section: Aerobic Exercisementioning

confidence: 99%

“…Of note, METs remained elevated at 24- and 36-months despite VO 2peak returning to near baseline levels [ 60 ]. Other studies, however, reported no change in physical activity status of CKD patients in response to exercise [ 61 – 63 ]. Therefore, future studies are warranted to determine the effects of exercise for improving physical activity levels in CKD patients and the potential interactions between physical activity level and adaptations to exercise.…”

Section: Physical Activitymentioning

confidence: 99%

Physical Activity and Exercise for Cardiorespiratory Health and Fitness in Chronic Kidney Disease

Gollie¹,

Cohen²,

Patel³

2022

Rev. Cardiovasc. Med.

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Chronic kidney disease (CKD) is associated with an increased risk for cardiovascular disease (CVD), major adverse CVD events, and cardiovascular mortality. Low levels of physical activity and reduced cardiorespiratory fitness further compound the health consequences in this patient population. Aerobic exercise alone and the combination of aerobic and resistance exercise have beneficial effects for improving aerobic capacity while resistance exercise alone improves strength and skeletal muscle health. Given the prevalence of CVD in CKD patients and limited treatment options targeting traditional and non-traditional CVD risk factors in this population, the incoroporation of physical activity and exercise into the care of CKD seems critical for improving patient outcomes. Therefore, the purpose of this narrative review is to discuss the evidence of physical activity and exercise in CKD patients and the effects on cardiovascular outcomes and fitness.

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A randomized trial of aerobic exercise in chronic kidney disease: Evidence for blunted cardiopulmonary adaptations

Cited by 11 publications

References 31 publications

A Predictive Scoring Model for Postoperative Tracheostomy in Patients Who Underwent Cardiac Surgery

A Predictive Scoring Model for Postoperative Tracheostomy in Patients Who Underwent Cardiac Surgery

Lifestyle Interventions, Kidney Disease Progression, and Quality of Life: A Systematic Review and Meta-analysis

Physical Activity and Exercise for Cardiorespiratory Health and Fitness in Chronic Kidney Disease

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