Pulmonary function and exercise tolerance are related to disease severity in pre-dialytic patients with chronic kidney disease: a cross-sectional study

Abstract

BackgroundChronic kidney disease (CKD) involves a progressive, irreversible loss of kidney function. While early-stage CKD patients may show changes in pulmonary function and lowered exercise tolerance, the role of the estimated glomerular filtration rate (eGFR) in these patterns remains unknown. The aim of this study was to investigated pulmonary function and exercise tolerance in pre-dialytic CKD patients.MethodsA cross-sectional study was carried out with 38 adult volunteers divided into a control group (CG), consisting of 9 healthy adults, and 29 pre-dialytic CKD patients in stages 3 (G3), 4 (G4), and 5 (G5). All participants underwent spirometric and manovacuometric tests, a cardiopulmonary exercise test (CPET), a 6-minute walk test (6MWT), and laboratory tests.ResultsThe significant differences was observed in maximal exercise tolerance, measured as peak oxygen consumption percentage (VO2peak) (mL/kg/min) (CG = 28.9 ± 7.8, G3 = 23.3 ± 5.6, G4 = 21.4 ± 5.2, G5 = 20.2 ± 6.9; p = 0.03), and submaximal exercise tolerance, measured by 6MWT (m) (CG = 627.6 ± 37.8, G3 = 577.4 ± 66.1, G4 = 542.7 ± 57.3, G5 = 531.5 ± 84.2, p = 0.01). The eGFR was associated with pulmonary function-forced expiratory volume in the first second percentage (FEV1) (%) (r = 0.34, p = 0.02) and maximum inspiratory pressure (PImax) (r = 0.41, p = 0.02) - and exercise tolerance - VO2peak (mL/kg/min) (r = 0.43, p = 0.01) and 6MWT distance (m) (r = 0.55, p < 0.01).ConclusionPre-dialytic CKD patients showed lower maximal and submaximal exercise tolerances than healthy individuals.

Effects of individualized exercise program on physical function, psychological dimensions, and health‐related quality of life in patients with chronic kidney disease: A randomized controlled trial in China

“…Chronic kidney disease (CKD) is a global public health problem associated with high prevalence, morbidity, and mortality. It is reported that the prevalence of CKD is 8% ~ 16% worldwide (Faria et al, ; Hiraki et al, ). In China, CKD is estimated to affect 10.8% of Chinese adults (Zhang et al, ).…”

Estimated Glomerular Filtration Rate and 6-Minute Walk Distance in African Americans with Mild to Moderate Heart Failure

“…Patients with early stage CKD are known to have lower functional capacity than healthy individuals [18]. In the subanalysis we conducted on mild to moderate CKD (stage 1-3), only patients with eGFR >30 mL/min/1.73 m 2 ( n = 44) were included.…”

“…Higher eGFR reflects better health status. As eGFR declines and kidney disease progresses, one expects metabolic/catabolic perturbances to interfere with functional capacity [18]. When evaluating the effect of eGFR on functional capacity in this population, one must consider mechanisms related to the cardiorenal crosstalk.…”

Respiratory muscle impairment in dialysis patients: can minimal dose of exercise limit the damage? A Preliminary study in a sample of patients enrolled in the EXCITE trial

“…Interestingly, dyspnea, respiratory muscle strength, lung function, and diffusion capacity improved after renal transplantation [12]. In addition, the biochemical composition of body fluids [13], interstitial lung edema, pleural effusion due to volume overload or increased capillary permeability, pulmonary hypertension, hemosiderosis, and weakness of the respiratory muscles can also be involved in functional respiratory limitations in CKD patients [14]. This limitation contributes to the poor exercise tolerance of these patients, considering that physical exercise requires interactions between the peripheral muscle and cardiovascular and respiratory systems and also that peripheral muscle weakness due to neuropathy and myopathy [15] may be involved.…”