title: Effects of exercise and lifestyle intervention on cardiovascular function in CKD.
abstract: OBJECTIVE
  CKD is associated with poor cardiorespiratory fitness (CRF). This predefined substudy determined the effect of exercise training and lifestyle intervention on CRF and explored the effect on cardiovascular risk factors and cardiac and vascular function.
  
  
  METHODS
  Between February 2008 and March 2010, 90 patients with stage 3-4 CKD were screened with an exercise stress echocardiogram before enrollment. Patients (n=83) were randomized to standard care (control) or lifestyle intervention. The lifestyle intervention included multidisciplinary care (CKD clinic), a lifestyle program, and aerobic and resistance exercise training for 12 months. CRF (peak Vo2), left ventricular function, arterial stiffness, anthropometric, and biochemical data were collected at baseline and 12 months.
  
  
  RESULTS
  Ten percent of randomized patients had subclinical myocardial ischemia at screening and completed the study without incident. There was no baseline difference among 72 patients who completed follow-up (36 in the lifestyle intervention group and 36 in the control group). The intervention increased peak Vo2 (2.8±0.7 ml/kg per minute versus -0.3±0.9 ml/kg per minute; P=0.004). There was small weight loss (-1.8±4.2 kg versus 0.7±3.7 kg; P=0.02) but no change in BP or lipids. Diastolic function improved (increased e' of 0.75±1.16 cm/s versus -0.47±1.0 cm/s; P=0.001) but systolic function was well preserved and did not change. The change in arterial elastance was attenuated (0.11±0.76 mmHg/ml versus 0.76±0.96 mmHg/ml; P=0.01). Δ peak Vo2 was associated with group allocation and improved body composition.
  
  
  CONCLUSIONS
  Exercise training and lifestyle intervention in patients with CKD produces improvements in CRF, body composition, and diastolic function.
authors: Schools of Human Movement Studies, University of Queensland, Australia.
authors: Erin J
authors: EJ
authors: Howden
authors: Rodel
authors: R
authors: Leano
authors: William
authors: W
authors: Petchey
authors: Jeff S
authors: JS
authors: Coombes
authors: Nicole M
authors: NM
authors: Isbel
authors: Thomas H
authors: TH
authors: Marwick
mesh_terms: D000328:Adult; D000368:Aged; D001794:Blood Pressure; D002320:Cardiovascular Physiological Phenomena; D008076:Cholesterol, HDL / Q000097:blood; D008078:Cholesterol, LDL / Q000097:blood; D004032:Diet; D015444:Exercise / Q000502:physiology*; D005080:Exercise Test; D005260:Female; D005919:Glomerular Filtration Rate; D006801:Humans; D008019:Life Style; D008297:Male; D008875:Middle Aged; D010101:Oxygen Consumption; D010809:Physical Fitness; D051436:Renal Insufficiency, Chronic / Q000503:physiopathology*; D012307:Risk Factors; D014280:Triglycerides / Q000097:blood; D059289:Vascular Stiffness; D016277:Ventricular Function, Left; D015431:Weight Loss
chemical_list: D008076:Cholesterol, HDL; D008078:Cholesterol, LDL; D014280:Triglycerides
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