Skeletal muscle dysfunction in chronic renal failure: effects of exercise

Adams, Gregory R.; Vaziri, Nosratola D.

doi:10.1152/ajprenal.00296.2005

Cited by 113 publications

(114 citation statements)

References 115 publications

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“…27 These cytokines have been shown to induce muscle atrophy through enhanced catabolism, which may impact oxygen utilization in these patients. 28 Castaneda et al 29 demonstrated that resistance training may reverse the malnutrition-inflammation complex associated with poor prognosis in individuals with CKD, and recent reviews have highlighted the antiinflammatory role of exercise in other disease states. 30 In our study, no cytokine measurements were performed.…”

Section: Discussionmentioning

confidence: 99%

Decreased Maximal Aerobic Capacity in Pediatric Chronic Kidney Disease

Weaver

Kimball

Knilans

et al. 2008

Journal of the American Society of Nephrology

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Adult and pediatric patients with ESRD have impaired maximum oxygen consumption (VO 2 max), a reflection of the cardiopulmonary system's ability to meet increased metabolic demands. We sought to determine factors associated with decreased VO 2 max in pediatric patients with different stages of CKD. VO 2 max was measured using a standardized exercise testing protocol in patients with stage 2 to 4 chronic kidney disease (CKD) (n ϭ 46), in renal transplant recipients (n ϭ 22), in patients treated with maintenance hemodialysis (n ϭ 12), and in age-matched healthy controls (n ϭ 33). VO 2 max was similar between children with stage 2 CKD and controls, whereas lower VO 2 max was observed among children with stage 3 to 4 CKD, those treated with hemodialysis, and transplant recipients. In univariate analysis, VO 2 max was significantly associated with body mass index, resting heart rate, C-reactive protein, serum triglycerides, serum creatinine, and measures of diastolic function; no significant associations with left ventricular structure or systolic function were identified. In multivariate regression analysis, patient category versus control and the presence of diastolic dysfunction were independent predictors of lower VO 2 max. These results suggest that aerobic capacity is decreased in the early stages of CKD in children and that lower VO 2 max can be predicted by the presence of diastolic dysfunction, even if systolic function is normal. Maximal aerobic capacity (VO 2 max) represents the cardiovascularsystem'sabilitytotakeup,distribute,andutilize oxygen to perform work during maximal exercise. Healthy individuals can sustain a three-fold increase in heart rate (HR) and a two-fold increase in stroke volume to generate maximal aerobic capacity. 1 Therefore, VO 2 max has been used to assess the capacity of the cardiovascular system to respond to metabolic challenge in numerous disease states including ESRD. 2,3 Impaired maximal aerobic capacity was observed in adult and adolescent patients with ESRD as well as after renal transplantation. [4][5][6][7] The significance of these findings was underscored by studies suggesting lower survival rates in adults with ESRD and decreased VO 2 max. 8 The impairedVO 2 maxinthesepatientswasassociatedwithseveralfactors,includinglowerserumalbumin,anemia,and chronic heart failure. 9 Symptomatic heart disease is a rare event in pediatric patients with CKD. However abnormal cardiac structure and function in children with CKD is well recognized. These patients have left ventricular (LV) diastolic dysfunction and increased LV mass even before the onset of ESRD. 10,11 LV systolic function is generally preserved at rest, but altered contractile reserve was observed during exercise in di-

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Section: Discussionmentioning

confidence: 99%

Decreased Maximal Aerobic Capacity in Pediatric Chronic Kidney Disease

Weaver

Kimball

Knilans

et al. 2008

Journal of the American Society of Nephrology

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“…In this context the CKD-induced LPL and VLDL receptor deficiencies limit the supplies of lipid fuel and construction material to the skeletal muscles, myocardium and adipose tissues [32]. Limitation of available lipid fuel can, in turn, contribute to muscle weakness, diminished exercise capacity and myocardial dysfunction which are common in CKD patients.…”

Section: Role Of Lipid Disorders In Wasting and Impaired Energy Metabmentioning

confidence: 99%

Role of dyslipidemia in impairment of energy metabolism, oxidative stress, inflammation and cardiovascular disease in chronic kidney disease

Vaziri

2013

Clin Exp Nephrol

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“…9,26 and also mitochondrial abnormalities. 9,27 In addition, HD patients can show a reduction in physical function and fitness, 2,9,28-30 with a decrease in peripheral muscle strength. 9,[31][32][33] Thus, muscle weakness present in CKD patients on HD can result from muscle atrophy.…”

Section: Resultsmentioning

confidence: 99%

“…9,31 The potential mechanisms through which CKD can negatively interfere with skeletal muscles are multifactorial and complex, and can result from alterations in muscle perfusion, substrate transferences, and intermediate catabolism by factors, such as metabolic acidosis, corticosteroid use, and release of pro-inflammatory cytokines. 9,27 Respiratory function alterations are one of the most frequent conditions in such patients. 8,9,10 However, despite CKD pulmonary repercussions, the physiological effects and possible pulmonary alterations of patients undergoing renal replacement therapy are not yet well known.…”

Section: Resultsmentioning

confidence: 99%

Efeitos do treinamento muscular inspiratório nos pacientes em hemodiálise

Silva¹,

Amaral²,

Monteiro³

et al. 2011

J. Bras. Nefrol.

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Introduction: Chronic kidney disease associated with hemodialysis treatment can have a variety of musculoskeletal complications, in addition to repercussions in pulmonary function. Objective: To evaluate the effects of inspiratory muscle training on inspiratory muscle strength, pulmonary function, and functional capacity in patients with chronic kidney failure undergoing hemodialysis. Method: Non-controlled clinical trial, comprising 15 individuals diagnosed with chronic kidney failure and undergoing hemodialysis. Maximum inspiratory (PI max ) and expiratory (PE max ) pressures were assessed by use of pressure vacuum meter reading. Pulmonary function was assessed by use of spirometry. Functional capacity was assessed by use of walked distance and oxygen consumption obtained in the six-minute walk test (6MWT). For eight weeks, the inspiratory muscle training (IMT) protocol was applied during hemodialysis sessions, with load set to 40% of PI max and weekly frequency of three alternate days. Results: A significant increase in the walked distance was observed after training (455.5 ± 98 versus 557.8 ± 121.0; p = 0.003). No statistically significant difference was observed in the other variables when comparing their pre-and post-training values. Conclusion: The study showed no statistically significant difference in respiratory muscle strength, pulmonary function, and oxygen consumption. An increase in the walked distance was observed in the 6MWT.

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Skeletal muscle dysfunction in chronic renal failure: effects of exercise

Cited by 113 publications

References 115 publications

Decreased Maximal Aerobic Capacity in Pediatric Chronic Kidney Disease

Decreased Maximal Aerobic Capacity in Pediatric Chronic Kidney Disease

Role of dyslipidemia in impairment of energy metabolism, oxidative stress, inflammation and cardiovascular disease in chronic kidney disease

Efeitos do treinamento muscular inspiratório nos pacientes em hemodiálise

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