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Exercise capacity in polycystic kidney disease.

Natália Lopes Reinecke1, Thulio Marquez Cunha2, Ita Pfeferman Heilberg1

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American Journal of Kidney Diseases : the Official Journal of the National Kidney Foundation
|May 3, 2014
PubMed
Summary

Young patients with autosomal dominant polycystic kidney disease (ADPKD) show reduced exercise capacity and abnormal nitric oxide and asymmetric dimethylarginine (ADMA) responses to exercise, indicating early endothelial dysfunction.

Keywords:
Autosomal dominant polycystic kidney disease (ADPKD)asymmetric dimethylarginine (ADMA)cardiopulmonary exercise testingcystic diseasesexercisenitric oxidephysical capacitypolycystic kidney

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Area of Science:

  • Nephrology
  • Cardiology
  • Exercise Physiology

Background:

  • Autosomal dominant polycystic kidney disease (ADPKD) is a genetic disorder.
  • Limited data exists on exercise performance in ADPKD patients.

Purpose of the Study:

  • To evaluate exercise capacity in normotensive ADPKD patients.
  • To assess nitric oxide and asymmetric dimethylarginine (ADMA) levels during exercise in ADPKD.

Main Methods:

  • Prospective controlled cohort study.
  • 26 ADPKD patients and 30 controls underwent cardiopulmonary exercise testing.
  • Measured serum/urinary nitric oxide, plasma ADMA, and blood pressure pre- and post-exercise.

Main Results:

  • ADPKD patients had significantly lower peak oxygen uptake and anaerobic threshold compared to controls.
  • Nitric oxide levels did not increase post-exercise in ADPKD patients, unlike in controls.
  • ADMA levels remained unchanged post-exercise in ADPKD patients, but decreased in controls.

Conclusions:

  • Young normotensive ADPKD patients exhibit reduced aerobic capacity.
  • Inadequate nitric oxide and ADMA responses to exercise suggest early endothelial dysfunction in ADPKD.
  • Further research is needed to explore flow-mediated dilation and oxidative status.