Kazuko Kotoku1,2, Tetsuhiko Yasuno3, Shotaro Kawakami4, Kanta Fujimi5, Takuro Matsuda5, Shihoko Nakashima6, Yoshinari Uehara6,7, Hiroaki Tanaka6,7, Takao Saito3, Yasuki Higaki8,9. 1. Graduate School of Sports and Health Science, Fukuoka University, 8-19-1 Nanakuma, Johnan-ku, Fukuoka, 814-0180, Japan. 2. Faculty of Medicine and Health Science, Yamaguchi University, 1-1-1, Minamiogushi, Ube, Yamaguchi, 755-8505, Japan. 3. Division of Nephrology and Rheumatology, Department of Internal Medicine, Fukuoka University School of Medicine, 7-45-1 Nanakuma, Johnan-ku, Fukuoka, 814-0133, Japan. 4. Department of Rehabilitation, Fukuoka University Chikushi Hospital, 1-1-1 Zokumyoin, Chikushino, Fukuoka, 818-0067, Japan. 5. Department of Rehabilitation, Fukuoka University Hospital, 7-45-1 Nanakuma, Johnan-ku, Fukuoka, 814-0133, Japan. 6. Laboratory of Exercise Physiology, Faculty of Sports and Health Science, Fukuoka University, 8-19-1 Nanakuma, Johnan-ku, Fukuoka, 814-0180, Japan. 7. Fukuoka University Institute for Physical Activity, 8-19-1 Nanakuma, Johnan-ku, Fukuoka, 814-0180, Japan. 8. Laboratory of Exercise Physiology, Faculty of Sports and Health Science, Fukuoka University, 8-19-1 Nanakuma, Johnan-ku, Fukuoka, 814-0180, Japan. higaki@fukuoka-u.ac.jp. 9. Fukuoka University Institute for Physical Activity, 8-19-1 Nanakuma, Johnan-ku, Fukuoka, 814-0180, Japan. higaki@fukuoka-u.ac.jp.
Abstract
BACKGROUND: Acute exercise reduces renal blood flow (RBF). However, the effect of exercise intensity on RBF in patients with chronic kidney disease (CKD) stage 2 is not known. We investigated the association between RBF and exercise intensity in patients with CKD stage 2 using pulsed Doppler ultrasonography. METHODS: Eight men with CKD stage 2 (cystatin C-based estimate of glomerular filtration rate: 60-89 ml/min/1.73 m2) participated in this study. Using a bicycle ergometer, participants undertook a maximal graded exercise test (MGET) (experiment 1) and a multi-stage exercise test (experiment 2) to determine their lactate threshold (LT). Participants undertook a multi-stage exercise test for 4-min each. Workloads of 60%, 80%, 100%, 120%, and 140% of LT were used in experiment 3. RBF was measured by pulsed Doppler ultrasonography at rest, immediately after exercise, and 1 h after exercise in experiment 1, and at rest and immediately after each exercise bout in experiment 3. RESULTS: Renal blood flow after the MGET was 52% lower than at rest, and did not recover as well as after the exercise test. Cross-sectional area (CSA) was significantly lower after graded exercise. RBF tended to be lower at 100% of LT and was significantly lower at 120% of LT. CSA was significantly lower at 100% of LT. CONCLUSIONS: Renal blood flow does not change during exercise until the LT is reached. These findings may assist in making appropriate exercise recommendations to patients with CKD stage 2.
BACKGROUND: Acute exercise reduces renal blood flow (RBF). However, the effect of exercise intensity on RBF in patients with chronic kidney disease (CKD) stage 2 is not known. We investigated the association between RBF and exercise intensity in patients with CKD stage 2 using pulsed Doppler ultrasonography. METHODS: Eight men with CKD stage 2 (cystatin C-based estimate of glomerular filtration rate: 60-89 ml/min/1.73 m2) participated in this study. Using a bicycle ergometer, participants undertook a maximal graded exercise test (MGET) (experiment 1) and a multi-stage exercise test (experiment 2) to determine their lactate threshold (LT). Participants undertook a multi-stage exercise test for 4-min each. Workloads of 60%, 80%, 100%, 120%, and 140% of LT were used in experiment 3. RBF was measured by pulsed Doppler ultrasonography at rest, immediately after exercise, and 1 h after exercise in experiment 1, and at rest and immediately after each exercise bout in experiment 3. RESULTS: Renal blood flow after the MGET was 52% lower than at rest, and did not recover as well as after the exercise test. Cross-sectional area (CSA) was significantly lower after graded exercise. RBF tended to be lower at 100% of LT and was significantly lower at 120% of LT. CSA was significantly lower at 100% of LT. CONCLUSIONS: Renal blood flow does not change during exercise until the LT is reached. These findings may assist in making appropriate exercise recommendations to patients with CKD stage 2.
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