title: Can young adult patients with proteinuric IgA nephropathy perform physical exercise?
abstract: BACKGROUND
  It is not known whether physical exercise increases daily proteinuria in patients with proteinuric nephropathies, thus accelerating progression of the renal lesion. This study evaluates the acute effects of physical exercise on proteinuria in young adults with immunoglobulin A (IgA) nephropathy.
  
  
  METHODS
  Changes induced by intense physical exercise on quantitative and qualitative proteinuria were evaluated in basal conditions and after 10 days of ramipril therapy in 10 patients with IgA nephropathy, normal glomerular filtration rate (GFR), proteinuria between 0.8 and 1.49 g/24 h, and "glomerular" microhematuria before and after the end of a maximal treadmill Bruce test (B-test). The basal study also was performed in 10 age- and sex-matched healthy volunteers.
  
  
  RESULTS
  At rest, GFR averaged 141 +/- 23 mL/min; it increased by 16.3% +/- 3.3% (P < 0.005) and 7.1% +/- 1.6% at 60 and 120 minutes after the B-test, respectively. At rest, GFR-corrected proteinuria averaged protein of 0.76 +/- 0.21 mg/min/100 mL GFR; it increased to 1.55 +/- 0.28 mg/min/100 mL GFR after 60 minutes (P < 0.001) and declined to 0.60 +/- 0.11 mg/min/100 mL GFR at 120 minutes after the end of the B-test. The pattern of urinary proteins remained unchanged, as did microhematuria. Daily proteinuria was not different from the basal value on the day of the B-test. After ramipril therapy, patients showed a reduction in GFR, but no change in daily GFR-corrected proteinuria, pattern of urinary proteins, or hematuria.
  
  
  CONCLUSIONS
  The increase in proteinuria after exercise in our patients is significant and is not prevented by ramipril therapy, but lasts less than 120 minutes. Therefore, it cannot modify daily proteinuria. Thus, these data do not support the need to reduce acute physical activity in patients with nonnephrotic renal diseases.
authors.affiliation: University Magna Graecia, Catanzaro, Italy. fuiano@unicz.it
authors.forename: Giorgio
authors.initials: G
authors.lastname: Fuiano
authors.forename: Domenico
authors.initials: D
authors.lastname: Mancuso
authors.forename: Paola
authors.initials: P
authors.lastname: Cianfrone
authors.forename: Nicola
authors.initials: N
authors.lastname: Comi
authors.forename: Giuseppe
authors.initials: G
authors.lastname: Mazza
authors.forename: Francesco
authors.initials: F
authors.lastname: Marino
authors.forename: Laura
authors.initials: L
authors.lastname: Fuiano
authors.forename: Pasquale
authors.initials: P
authors.lastname: Zamboli
authors.forename: Alfredo
authors.initials: A
authors.lastname: Caglioti
authors.forename: Michele
authors.initials: M
authors.lastname: Andreucci
mesh_terms: D000328:Adult; D000450:Aldosterone / Q000097:blood; D000806:Angiotensin-Converting Enzyme Inhibitors / Q000627:therapeutic use; D016022:Case-Control Studies; D003404:Creatinine / Q000097:blood; D018450:Disease Progression; D005080:Exercise Test; D017079:Exercise Tolerance; D005260:Female; D005922:Glomerulonephritis, IGA / Q000150:complications / Q000503:physiopathology* / Q000652:urine; D006417:Hematuria / Q000209:etiology; D006801:Humans; D007687:Kidney Tubules, Proximal / Q000378:metabolism; D008297:Male; D011507:Proteinuria / Q000209:etiology*; D017257:Ramipril / Q000627:therapeutic use; D012083:Renin / Q000097:blood
chemical_list: D000806:Angiotensin-Converting Enzyme Inhibitors; D000450:Aldosterone; D003404:Creatinine; D012083:Renin; D017257:Ramipril