Exercise as an Adjunct Therapy to Reduce Blood Pressure in Chronic Kidney Disease

Study Overview
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Brief Summary
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The general objective of the study is to investigate the effect of regular aerobic exercise on resting and 24-hr blood pressure levels in men and women with stage 3-4 kidney disease and hypertension.

Official Title
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Exercise as an Adjunct Therapy to Reduce Blood Pressure in Chronic Kidney Disease

Conditions
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Focus Chronic Kidney Disease With Hypertension

Intervention / Treatment
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* Behavioral: Exercise


Participation Criteria
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Eligibility Criteria
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Inclusion Criteria: • Non-diabetic and >18 years of age Diagnosed kidney disease with associated hypertension: Non-nephrotic range proteinuria at diagnosis No active glomerular disease or concomitant systemic inflammatory disease (e.g. lupus) Systolic blood pressure >130 and/or diastolic blood pressure >80 mm Hg (on medication) An estimated glomerular filtration rate of between 60 ml/min and 15 ml/min. Individuals must be able to provide informed consent Perform walking exercise training on a treadmill Be able to participate in a 12-week supervised exercise program. Exclusion Criteria: Currently participating in a formal exercise program Diabetes, active glomerular disease, or systemic inflammatory disease Requiring dialysis Have an Hematocrit <27% Uncontrolled hypertension (>200/110mmHg) Peripheral vascular disease. An inability to understand English or give consent. Other exclusion criteria are: any contraindications to exercise testing or training as indicated by the American College of Sports Medicine guidelines such as: Unstable coronary heart disease and symptomatic heart failure, exercise capacity limited by health problems such as angina, severe arthritis, or extreme dyspnea on exertion, progressive neuromuscular disease, pulmonary disease, or having undergone a coronary revascularization within the past 6 months prior to enrollment.

Ages Eligible for Study
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Minimum Age: 18 Years
Maximum Age: 80 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: Exercise<br>12 weeks of blended supervised-home based exercise 3-4 times per week for 30-45 minutes | Behavioral: Exercise<br>* Blended supervised-home based walking exercise 3-4 times per week for 30-45 minutes<br>|
| No Intervention: control<br>Control group asked to continue usual activities | |

What is the study measuring?
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Primary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| blood pressure | resting and 24-hour ambulatory blood pressure | at week 0 and at week 12 | 

Secondary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| effective vascular compliance | Pulse wave velocity estimated systemic vascular resistance | at week 0 and at week 12 | 
| endothelial function | measured by brachial artery flow mediated vasodilation | at week 0 and at week 12 | 
| biomarkers associated with blood pressure | Circulating levels of angiotensin 2 Circulating levels of endothelin 1 asymmetric dimethylarginine | at week 0 and at week 12 | 

 Terms related to the study
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Keywords Provided by Centre Hospitalier Valida
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Exercise, blood pressure, chronic kidney disease