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Assessment of Vascular Function in Patients With Chronic Kidney Disease
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Exercise modulates sympathetic and vascular function in chronic kidney disease.

Jinhee Jeong1,2, Justin D Sprick1,2,3, Dana R DaCosta1,2

  • 1Division of Renal Medicine, Department of Medicine, Emory University School of Medicine, Atlanta, Georgia, USA.

JCI Insight
|February 22, 2023
PubMed
Summary

Aerobic exercise training, specifically cycling, can reduce sympathetic nervous system activity and improve neurovascular function in patients with chronic kidney disease (CKD). This intervention effectively counteracted increases seen in a control group, benefiting those with higher baseline activity.

Keywords:
Chronic kidney diseaseClinical TrialsNeuroscience

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Area of Science:

  • Nephrology
  • Cardiology
  • Exercise Physiology

Background:

  • Chronic kidney disease (CKD) is linked to overactive sympathetic nervous system (SNS), increasing cardiovascular disease risk.
  • SNS overactivity contributes to vascular stiffness, a key factor in cardiovascular complications.

Purpose of the Study:

  • To investigate if aerobic exercise training reduces resting SNS activity and vascular stiffness in CKD patients.
  • To test the hypothesis that exercise training improves neurovascular function in this population.

Main Methods:

  • A 12-week randomized controlled trial involving sedentary older adults with CKD.
  • Participants engaged in either cycling exercise or a stretching control group, 3 days/week.
  • Primary outcomes measured included muscle sympathetic nerve activity (MSNA), pulse wave velocity (PWV), and augmentation index (AIx).

Main Results:

  • Aerobic exercise training did not change MSNA or AIx in the exercise group, while the stretching group showed increases.
  • A significant group-by-time interaction was observed for MSNA and AIx.
  • No significant changes in arterial stiffness (PWV) were found in either group.

Conclusions:

  • Twelve weeks of cycling exercise demonstrated beneficial neurovascular effects in CKD patients.
  • Exercise training effectively reduced the increase in MSNA and AIx observed in the control group.
  • The sympathoinhibitory effect was more pronounced in CKD patients with higher baseline MSNA.