Resistance Exercise Training in Chronic Kidney Disease

Study Overview
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Brief Summary
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The investigators aim to evaluate the feasibility of a resistance exercise training program among individuals with CKD and its impact on endothelial and vascular function.

Detailed Description
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Resistance exercise training has been shown to improve cardiovascular health including endothelial function in general populations, but studies in patients with chronic kidney disease (CKD) are limited. The investigators aim to evaluate the feasibility and acceptability of a resistance exercise training program among individuals with CKD and its impact on endothelial and vascular function as measured by brachial artery flow-mediated dilation, pulse-wave velocity and carotid artery stiffness. To accomplish this goal the investigators propose to conduct a 12-week pilot randomized controlled trial of twice a week resistance exercise training among 32 adults with CKD. The results of this study will inform the design and implementation of a larger trial evaluating the impact of resistance exercise training on adverse outcomes in patients with CKD including CKD progression.

Official Title
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Effect of Resistance Exercise Training on Endothelial Function and Cardiovascular Risk Factors in Patients With Chronic Kidney Disease

Conditions
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Chronic Kidney Disease

Intervention / Treatment
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* Behavioral: Resistance exercise training


Participation Criteria
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Eligibility Criteria
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Inclusion Criteria: CKD stage 3 or 4 (eGFR 15-60 ml/min/1.73m2) Exclusion Criteria: Currently institutionalized Kidney transplant or dialysis NY Heart Association class 3-4 heart failure Dementia or cognitive impairment Unstable angina or coronary revascularization within the last 3 months Uncontrolled arrhythmia Severe chronic lung disease Orthopedic, neurologic or other condition that would preclude resistance exercise training Pregnancy Uncontrolled hypertension (systolic > 160 mmHg and diastolic >90 mmHg)

Ages Eligible for Study
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Minimum Age: 21 Years

Sexes Eligible for Study
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All

Accepts Healthy Volunteers
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No

Study Plan
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How is the study designed?
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Design Details

Primary Purpose: Treatment
Allocation: Randomized
Intervention Model: Parallel Assignment
Masking: Single


Arms and Interventions

| Participant Group/Arm | Intervention/Treatment |
| --- | --- |
| Experimental: Resistance exercise training program<br>Eight exercises will be used to include large upper and lower body muscle groups. The baseline 1 repetition maximum (RM) will be used to set initial training loads. All exercise sessions will be performed under the supervision of an exercise physiologist. Vital signs and body weight will be recorded before each session. The workload during training will be adjusted to reflect 80% of the most recent 1 RM (approximately 8-12 RM set). In addition, patients' workloads will be progressively increased if the patients can lift the weight more than 12 repetitions. Participants will perform three sets of 8-12 repetitions on each machine per session. | Behavioral: Resistance exercise training<br>* 12-week resistance exercise training program, 2 times per week, 45 min per session. Eight exercises will be used to include large upper and lower body muscle groups (leg press, leg extension, leg curl, chest press, shoulder extension, biceps curl, abdominal crunch and back extension). The baseline one repetition maximum will be used to set initial training loads.<br>|
| No Intervention: Control<br>Participants randomized to the control group will be offered an educational brochure regarding exercise published by the NKF. | |

What is the study measuring?
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Primary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Endothelial function | Measured by brachial artery flow-mediated dilation (FMD) | 3 months | 

Secondary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Vascular function | Measured by pulse wave velocity | 3 months | 
| Carotid artery stiffness | Measured by non-invasive ultrasound | 3 months | 
| Self-reported physical activity | Assessed by the MESA (Multiethnic Study of Atherosclerosis) Typical Week Physical Activity Survey | 3 months | 
| Objectively measured physical activity | Assessed by a physical activity monitor (ActiGraph GT3X+) | 3 months | 
| Systolic blood pressure | Measured using standard procedures | 3 months | 
| Serum LDL-cholesterol | Measured using standard procedures | 3 months | 
| Serum HDL-cholesterol | Measured using standard procedures | 3 months | 
| Muscle strength | Assessed by the amount of weight lifted in a single chest press and leg press (1 RM). | 3 months |