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Stretching Does Not, Aerobic Exercise Does Improve Endothelial Function in CKD Patients

J Appl Physiol 2022 Feb 10. Aerobic Exercise Training Improves Endothelial Function and Attenuates Blood Pressure Reactivity during Maximal Exercise in Chronic Kidney Disease Justin D Sprick 1 2 3, Kevin Mammino 2 3, Jin Hee Jeong 1 2 3, Dana R DaCosta 1 2 3, Yingtian Hu 4, Doree G Morison 1 2, Joe R Nocera 2 3 5, Jeanie Park 1 2 3

Abstract Chronic Kidney Disease (CKD) patients have exaggerated increases in blood pressure during exercise that are associated with endothelial dysfunction. We hypothesized that aerobic exercise training would improve endothelial function and attenuate blood pressure reactivity during exercise in CKD. Sedentary individuals with CKD stages III-IV underwent 12 weeks of aerobic cycling exercise (N=26) or nonaerobic exercise (N=22, control). Both interventions were performed 3 days/week and matched for duration. Endothelial function was measured via peripheral arterial tonometry and quantified as reactive hyperemia index (RHI). Peak oxygen uptake (VO2peak) was assessed via maximal treadmill exercise testing with concomitant blood pressure monitoring. All measurements were performed at baseline and following the 12-week intervention. A linear mixed model was used to compare the rate of increase in blood pressure during the test. RHI improved with exercise (Pre=1.78±0.10 vs Post=2.01±0.13, P=0.03) with no change following stretching (Pre=1.73±0.08 vs Post=1.67±0.10, P=0.69). Peak systolic blood pressure during the maximal treadmill exercise test was lower following exercise training (Pre=186±5mmHg, Post=174±4mmHg, P=0.003) with no change following stretching (Pre=190±6mmHg, Post=190±4mmHg, P=0.69). The rate of increase in systolic blood pressure during the VO2peak test tended to decrease following training for both groups (-2mmHg/stage) with no differences between groups (P=0.97). There was no change in VO2peak following either intervention. In conclusion, aerobic exercise training improves endothelial function and attenuates peak blood pressure reactivity during exercise in CKD. Keywords: Exercise Testing; Hypertension; Neural Control of Circulation; Reactive Hyperemia Index; VO2peak.

Life (Basel) 2022 Jan 9;12(1):91. The Influence of an Acute Bout of Aerobic Exercise on Vascular Endothelial Function in Moderate Stages of Chronic Kidney Disease Jeffrey S Forsse 1, Zacharias Papadakis 2, Matthew N Peterson 3, James Kyle Taylor 4, Burritt W Hess 5, Nicholas Schwedock 5, Dale C Allison 6, Jackson O Griggs 5, Ronald L Wilson 6, Peter W Grandjean 7 Abstract Chronic kidney disease (CKD) is directly influenced by the deleterious effects of systemic inflammation and oxidative stress. The vascular endothelium may transiently respond to aerobic exercise and improve post-exercise vascular renal function in moderate stages of CKD. Brachial artery flow-mediated dilation (FMD) is a nitric-oxide-dependent measure of endothelial function that is transiently potentiated by exercise. The purpose of the study was to determine the acute influence of a single bout of high-intensity interval exercise (HIIE) or steady-state moderate-intensity exercise (SSE) on endothelial dysfunction in moderate stages of CKD. Twenty participants (n = 6 men; n = 14 women) completed 30 min of SSE (65%) and HIIE (90:20%) of VO2reserve in a randomized crossover design. FMD measurements and blood samples were obtained before, 1 h, and 24 h post-exercise. FMD responses were augmented 1 h post-exercise in both conditions (p < 0.005). Relative to pre-exercise measures, total antioxidant capacity increased by 4.3% 24 h post-exercise (p = 0.012), while paraoxonase-1 was maintained 1 h and elevated by 6.1% 24 h after SSE, but not HIIE (p = 0.035). In summary, FMD can be augmented by a single episode of either HIIE or SSE in moderate stages of CKD. Modest improvements were observed in antioxidant analytes, and markers of oxidative stress were blunted in response to either SSE or HIIE. Keywords: antioxidants; flow-mediated dilation; high-intensity interval exercise; steady-state exercise.


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