title: Effect of Moderate Aerobic Exercise Training on Endothelial Function and Arterial Stiffness in CKD Stages 3-4: A Randomized Controlled Trial.
abstract: BACKGROUND
  Evidence of a beneficial effect of exercise training on mediators of vascular disease is accumulating in chronic kidney disease (CKD), but its effect on vascular function in vivo still has to be established. The present study was designed to investigate whether a formal aerobic exercise training program improves peripheral endothelial function in patients with CKD stages 3 to 4.
  
  
  METHODS
  Randomized controlled trial with a parallel-group design.
  
  
  METHODS
  48 patients with CKD stages 3 to 4 without established cardiovascular disease were randomly assigned to either an exercise training program or usual care. 40 patients completed the study (exercise training, 19; usual care, 21).
  
  
  METHODS
  The 3-month home-based aerobic training program consisted of 4 daily cycling sessions of 10 minutes each at a target heart rate, calculated as 90% of the heart rate achieved at the anaerobic threshold. Patients in the usual-care group were given standard therapy.
  
  
  RESULTS
  The primary outcome was peripheral endothelial function. Secondary outcomes were aerobic capacity, arterial stiffness, numbers of endothelial (EPCs) and osteogenic progenitor cells (OPCs), migratory function of circulatory angiogenic cells, and health-related quality of life.
  
  
  METHODS
  Endothelial function was assessed with flow-mediated dilation of the brachial artery, aerobic capacity by peak oxygen uptake (VO(2peak)), arterial stiffness by carotid-femoral pulse wave velocity, numbers of EPCs and OPCs by flow cytometry, circulatory angiogenic cell function by an in vitro migratory assay, and quality of life by the Kidney Disease Quality of Life-Short Form questionnaire.
  
  
  RESULTS
  Exercise training significantly improved VO(2peak) and quality of life, but not in vivo vascular function (flow-mediated dilation and carotid-femoral pulse wave velocity) or cellular markers for vascular function (EPC and OPC count and circulatory angiogenic cell migratory function).
  
  
  CONCLUSIONS
  Short duration and intermittent nature of the exercise intervention.
  
  
  CONCLUSIONS
  In patients with CKD stages 3 to 4 without overt cardiovascular disease, 3 months of aerobic exercise training improved VO(2peak) and quality of life, without altering endothelial function or arterial stiffness.
authors.affiliation: Department of Nephrology, Antwerp University Hospital, Edegem, Belgium; Laboratory for Molecular and Cellular Cardiology, University of Antwerp, Edegem, Belgium; Laboratory of Experimental Medicine and Pediatrics, University of Antwerp, Edegem, Belgium. Electronic address: amaryllis.vancraenenbroeck@uantwerpen.be.
authors.forename: Amaryllis H
authors.initials: AH
authors.lastname: Van Craenenbroeck
authors.affiliation: Laboratory for Molecular and Cellular Cardiology, University of Antwerp, Edegem, Belgium; Department of Cardiology, Antwerp University Hospital, Edegem, Belgium.
authors.forename: Emeline M
authors.initials: EM
authors.lastname: Van Craenenbroeck
authors.affiliation: Laboratory for Molecular and Cellular Cardiology, University of Antwerp, Edegem, Belgium.
authors.forename: Katrijn
authors.initials: K
authors.lastname: Van Ackeren
authors.affiliation: Laboratory for Molecular and Cellular Cardiology, University of Antwerp, Edegem, Belgium; Department of Cardiology, Antwerp University Hospital, Edegem, Belgium.
authors.forename: Christiaan J
authors.initials: CJ
authors.lastname: Vrints
authors.affiliation: Laboratory for Molecular and Cellular Cardiology, University of Antwerp, Edegem, Belgium; Department of Cardiology, Antwerp University Hospital, Edegem, Belgium.
authors.forename: Viviane M
authors.initials: VM
authors.lastname: Conraads
authors.affiliation: Laboratory of Experimental Medicine and Pediatrics, University of Antwerp, Edegem, Belgium.
authors.forename: Gert A
authors.initials: GA
authors.lastname: Verpooten
authors.affiliation: Laboratory of Sports Medicine, Aristotle University of Thessaloniki, Thessaloniki, Greece.
authors.forename: Evangelia
authors.initials: E
authors.lastname: Kouidi
authors.affiliation: Department of Nephrology, Antwerp University Hospital, Edegem, Belgium.
authors.forename: Marie M
authors.initials: MM
authors.lastname: Couttenye
mesh_terms: D000328:Adult; D000368:Aged; D002318:Cardiovascular Diseases / Q000209:etiology / Q000628:therapy; D002452:Cell Count; D002465:Cell Movement; D066026:Endothelial Progenitor Cells; D004730:Endothelium, Vascular; D015444:Exercise; D005081:Exercise Therapy / Q000379:methods*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D010101:Oxygen Consumption; D063177:Pulse Wave Analysis; D011788:Quality of Life; D051436:Renal Insufficiency, Chronic / Q000150:complications / Q000628:therapy*; D059289:Vascular Stiffness; D014664:Vasodilation
keywords: Chronic kidney disease (CKD); aerobic capacity; aerobic exercise; arterial stiffness; cardiovascular disease prevention; endothelial dysfunction; exercise training; intermittent training; quality of life; randomized controlled trial