Vascular effects of exercise training in CKD: current evidence and pathophysiological mechanisms.
Cardiovascular disease remains the main cause of morbidity and mortality in patients with CKD, an observation that cannot be explained by the coexistence of traditional risk factors alone. Recently, other mechanisms, such as alterations in nitric oxide bioavailability, impaired endothelial repair mechanisms, inflammation, and oxidative stress (all characteristic in CKD), have gained much attention as mediators for the increased cardiovascular risk. Regular physical training is a valuable nonpharmacological intervention for primary and secondary prevention of cardiovascular disease. Likewise, the benefits of exercise training on exercise capacity and quality of life are increasingly recognized in patients with CKD. Furthermore, exercise training could also influence potential reversible mechanisms involved in atherosclerosis and arteriosclerosis. After discussing briefly the general concepts of vascular disease in CKD, this review provides an overview of the current evidence for the effects of exercise training at both clinical and preclinical levels. It concludes with some practical considerations on exercise training in this specific patient group.
Departments of Nephrology and Laboratory for Molecular and Cellular Cardiology, University of Antwerp, Edegem, Belgium; and amaryllis.vancraenenbroeck@ua.ac.be.
Amaryllis H
AH
Van Craenenbroeck
Laboratory for Molecular and Cellular Cardiology, University of Antwerp, Edegem, Belgium; and Cardiology, Antwerp University Hospital, Edegem, Belgium;
Emeline M
EM
Van Craenenbroeck
School of Physical Education and Sports Sciences, Aristotle University of Thessaloniki, Thessaloniki, Greece.
Evangelia
E
Kouidi
Laboratory for Molecular and Cellular Cardiology, University of Antwerp, Edegem, Belgium; and Cardiology, Antwerp University Hospital, Edegem, Belgium;
Christiaan J
CJ
Vrints
Departments of Nephrology and.
Marie M
MM
Couttenye
Laboratory for Molecular and Cellular Cardiology, University of Antwerp, Edegem, Belgium; and Cardiology, Antwerp University Hospital, Edegem, Belgium;
Viviane M
VM
Conraads
D000818:Animals; D001158:Arteries / Q000378:metabolism / Q000473:pathology / Q000503:physiopathology*; D015897:Comorbidity; D005081:Exercise Therapy; D006439:Hemodynamics; D006801:Humans; D051436:Renal Insufficiency, Chronic / Q000175:diagnosis / Q000453:epidemiology / Q000378:metabolism / Q000503:physiopathology / Q000628:therapy*; D012307:Risk Factors; D016896:Treatment Outcome; D014652:Vascular Diseases / Q000175:diagnosis / Q000453:epidemiology / Q000378:metabolism / Q000503:physiopathology / Q000628:therapy*
glomerular filtration; glomerulus; renal physiology