Urinary Markers of Kidney Injury in Chronic Kidney Disease Patients Following 12 Weeks of Exercise Training

Abstract

It is well established that individuals with chronic kidney disease (CKD) have diminished cardiorespiratory fitness compared to age‐matched healthy individuals and this deficit in fitness is associated with worsened clinical outcomes. As such, exercise training is recommended as an adjunct therapy for a myriad of health benefits in this population. However, further investigation is warranted into the effects of exercise training on kidney health and function in CKD. Therefore, the purpose of this trial was to investigate the effects of 12 weeks of moderate‐vigorous intensity aerobic training on urinary markers of kidney injury, kidney injury molecule 1 (KIM‐1) and neutrophil gelatinase‐associated lipocalin (NGAL). Twenty‐four stage 3 and 4 CKD patients (age: 59 ± 12 yr; eGFR: 43 ± 12 mL/min/1.73m2) were randomly allocated to exercise training (EXT, n=13) or a sedentary control condition (CON, n=11) for 12 weeks. EXT participated in 45 min of individually supervised aerobic activity 3 times per week at 60–85% of heart rate reserve while CON received routine care. Outcome measures were assessed at baseline and following 12 weeks. VO2peak was assessed with a 15 watt/min ramp protocol on a cycle ergometer. Urinary KIM‐1 and NGAL were assessed with commercially available ELISA kits and concentrations of each were normalized to urine creatinine concentration. Groups were matched for age, BMI, and eGFR. Following 12 weeks, EXT showed an increase in VO2peak compared to CON (P<0.05). There was not a significant time by condition interaction for urinary KIM‐1 (Baseline vs. Post; CON: 9 ± 4.3 vs 11.9 ± 7.7 ng/mgCr; EXT: 14.2 ± 20.2 vs 15.1 ± 21.5 ng/mgCr, P=0.84). Likewise, NGAL was also unchanged by time or condition (Baseline vs. Post; CON: 207.8 ± 301.7 vs 281 ± 356.5 ng/mgCr; EXT: 126.5 ± 190.5 vs 262.8 ± 459.7 ng/mgCr, P=0.65). These results indicate that moderate – vigorous intensity aerobic exercise improves cardiorespiratory fitness in CKD patients, and does not increase markers of kidney injury as measured by urinary KIM‐1 or NGAL. These data demonstrate that moderate to vigorous aerobic exercise is safe for CKD patient in terms of acute kidney injury.Support or Funding InformationThis research was supported by National Heart, Lung, and Blood Institute Grant HL‐113514.This abstract is from the Experimental Biology 2019 Meeting. There is no full text article associated with this abstract published in The FASEB Journal.