Background
Methods
Study Design
Study Sample
Inclusion Criteria | Exclusion Criteria |
---|---|
CKD Stages 2-4 | CKD stages other than 2-4 |
BMI ≥ 30 | Hyperparathyroidism/osteoporosis |
Diabetes mellitus | Symptomatic neuropathy/retinopathy |
Proteinuria (urine protein/creatinine > 200 mg/g for ≥ 3 months) | Positive stress test due to coronary arterial disease |
Treatment with ACE inhibitor or ARB, aspirin, and statin (if LDL > 100) | Symptomatic cardiovascular disease |
Congestive heart failure (New York Heart Association Class III or IV) | |
Chronic obstructive pulmonary disease (FEV1 < 50% predicted and/or requires supplemental oxygen support during exercise) | |
Complaints of angina during the stress test | |
Cerebrovascular disease/cognitive impairment | |
Renal transplant | |
Inability to walk on the treadmill | |
Any unforeseen illness or disability that would preclude exercise testing or training | |
Participation in a formal exercise program within the previous 12 weeks |
Study Procedures
Aerobic Training Protocol
Weeks | Light (25-44% VO2 peak) | Moderate (45-59% VO2 peak) | Hard (60-84% VO2 peak) | Very Hard (>85% VO2 peak) |
---|---|---|---|---|
1-3 | 20% (6 min) | 60% (18 min) | 20% (6 min) | 0% |
4-6 | 15% (6 min) | 55% (22 min) | 30% (12 min) | 0% |
Exercise-induced Hypoglycemia
Control group protocol
Specific Methods
Symptom-limited treadmill test protocol
Nutritional and Body Composition Assessment
Data Analysis
Results
Exercise Parameters | Baseline | 6 weeks | 24 weeks |
---|---|---|---|
Exercise duration (min) | 6.6 ± 2.2 | 11.3 ± 2.4 | 10.2 ± 2.8 |
Maximal oxygen consumption (mL/kg/min) | 14.9 ± 1.1 | 13.8 ± 3.9 | 15.6 ± 2.4 |
Oxygen consumption (isotime) (mL/kg/min) | 11.9 ± 1.7 | 10.0 ± 0.7 | 9.8 ± 1.4 |
Resting heart rate (bpm) | 80 ± 16 | 82 ± 22 | 81 ± 21 |
Maximum heart rate (bpm) | 116 ± 16 | 121 ± 14 | 118 ± 17 |
Resting systolic blood pressure (mmHg) | 130 ± 28 | 132 ± 13 | 113 ± 16 |
Resting diastolic blood pressure (mmHg) | 71 ± 20 | 71 ± 11 | 65 ± 10 |
Maximum systolic blood pressure (mmHg) | 182 ± 16 | 188 ± 24 | 165 ± 21 |
Maximum RPP# | 21094 ± 3475 | 22616 ± 1983 | 19206 ± 1402 |
Mean ± SD # rate pressure product = heart rate × systolic blood pressure | |||
Renal Function Parameters | Baseline | 6 weeks | 24 weeks |
Serum creatinine (mg/dL) | 2.9 ± 1.5 | 2.7 ± 1.3 | 2.8 ± 1.2 |
Serum urea nitrogen (mg/dL) | 64 ± 40 | 58 ± 48 | 57 ± 34 |
Creatinine clearance (mL/min) | 64 ± 54 | 62 ± 40 | 51 ± 26 |
Urea clearance (mL/min) | 24 ± 20 | 28 ± 22 | 26 ± 19 |
Glomerular filtration rate (mL/min)# | 44 ± 36 | 45 ± 31 | 39 ± 22 |
Urine albumin/creatinine (mg/g) | 327 ± 385 | 242 ± 260 | 305 ± 456 |
Urine protein/creatinine (mg/g) | 565 ± 600 | 419 ± 417 | 493 ± 544 |
Urine protein excretion (mg/24 h) | 1020 ± 1081 | 891 ± 831 | 821 ± 1010 |
# (Creatinine clearance + urea clearance)/2 | |||
Biochemical Parameters | Baseline | 6 weeks | 24 weeks |
Hemoglobin (g/dL) | 12.7 ± 2.1 | 12.7 ± 2.2 | 12.5 ± 1.8 |
Total cholesterol (mg/dL) | 125 ± 25 | 116 ± 17 | 128 ± 25 |
Low density cholesterol (mg/dL) | 59 ± 17 | 51 ± 16 | 54 ± 11 |
High density cholesterol (mL/min) | 38 ± 6 | 37 ± 5 | 39 ± 7 |
Triglycerides (mg/dL) | 137 ± 45 | 144 ± 60 | 179 ± 89 |
Glycated hemoglobin (%) | 7.4 ± 1.1 | 7.5 ± 1.2 | 8.3 ± 2.4 |
C-reactive protein (mg/dL) | 0.55 ± 0.72 | 0.72 ± 0.99 | 0.89 ± 0.92 |
Nutrition/Body Composition Parameters | Baseline | 6 weeks | 24 weeks |
Calorie intake (kcal/day) | 1878 ± 563 | 2011 ± 396 | 1939 ± 656 |
Body weight (kg) | 116 ± 27 | 116 ± 26 | 115 ± 23 |
Fat weight (%) | 40 ± 3 | 40 ± 3 | 40 ± 4 |
Lean weight (%) | 60 ± 3 | 60 ± 3 | 60 ± 4 |
Exercise Parameters | Baseline | 6 weeks | 24 weeks |
---|---|---|---|
Exercise duration (min) | 4.3 ± 1.1 | 5.5 ± 3.2 | 6.6 ± 2.1 |
Maximal oxygen consumption (mL/kg/min) | 10.9 ± 1.0 | 11.8 ± 2.0 | 11.9 ± 1.3 |
Oxygen consumption (isotime) (mL/kg/min) | 9.1 ± 0.3 | 9.0 ± 0.2 | 9.8 ± 0.5 |
Resting heart rate (bpm) | 75 ± 16 | 76 ± 10 | 70 ± 19 |
Maximum heart rate (bpm) | 112 ± 16 | 107 ± 16 | 105 ± 13 |
Resting systolic blood pressure (mmHg) | 157 ± 14 | 156 ± 23 | 136 ± 5 |
Resting diastolic blood pressure (mmHg) | 83 ± 20 | 77 ± 12 | 77 ± 8 |
Maximum systolic blood pressure (mmHg) | 207 ± 28 | 188 ± 47 | 184 ± 22 |
Maximum RPP# | 23219 ± 6046 | 20939 ± 7809 | 19373 ± 4215 |
Mean ± SD # rate pressure product = heart rate × systolic blood pressure | |||
Renal Function Parameters | Baseline | 6 weeks | 24 weeks |
Serum creatinine (mg/dL) | 2.3 ± 0.1 | 2.1 ± 0.2 | 2.1 ± 0.4 |
Serum urea nitrogen (mg/dL) | 45 ± 11 | 48 ± 12 | 50 ± 18 |
Creatinine clearance (mL/min) | 66 ± 19 | 54 ± 22 | 64 ± 10 |
Urea clearance (mL/min) | 28 ± 0.2 | 18 ± 5.7 | 19 ± 0.5 |
Glomerular filtration rate (mL/min)# | 47 ± 9.5 | 36 ± 14 | 41 ± 5.3 |
Urine albumin/creatinine (mg/g) | 156 ± 148 | 162 ± 173 | 221 ± 304 |
Urine protein/creatinine (mg/g) | 347 ± 178 | 305 ± 186 | 387 ± 374 |
Urine protein excretion (mg/24 h) | 542 ± 258 | 383 ± 256 | 490 ± 237 |
# (Creatinine clearance + urea clearance)/2 | |||
Biochemical Parameters | Baseline | 6 weeks | 24 weeks |
Hemoglobin (g/dL) | 11.8 ± 1.9 | 12.0 ± 1.8 | 11.9 ± 1.3 |
Total cholesterol (mg/dL) | 152 ± 38 | 160 ± 53 | 146 ± 31 |
Low density cholesterol (mg/dL) | 75 ± 24 | 80 ± 41 | 69 ± 22 |
High density cholesterol (mL/min) | 33 ± 6 | 31 ± 3 | 31 ± 4 |
Triglycerides (mg/dL) | 223 ± 92 | 245 ± 44 | 225 ± 104 |
Glycated hemoglobin (%) | 8.2 ± 1.7 | 8.7 ± 2.6 | 8.1 ± 3.7 |
C-reactive protein (mg/dL) | 1.7 ± 2.4 | 0.73 ± 0.32 | 1.17 ± 0.71 |
Body Composition Parameters | Baseline | 6 weeks | 24 weeks |
Calorie intake (kcal/day) | 1869 ± 13 | 2165 ± 658 | 2192 ± 537 |
Body weight (kg) | 140 ± 15 | 139 ± 15 | 136 ± 20 |
Fat weight (%) | 50 ± 5 | 53 ± 3 | 50 ± 5 |
Lean weight (%) | 50 ± 5 | 47 ± 3 | 50 ± 5 |