Mechanisms of Muscle Blood Flow Dysregulation and Exercise Intolerance in Chronic Kidney Disease
NCT ID: NCT02664519
Last Updated: 2021-03-23
Study Results
The study team has not published outcome measurements, participant flow, or safety data for this trial yet. Check back later for updates.
Basic Information
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TERMINATED
NA
32 participants
INTERVENTIONAL
2016-01-31
2021-03-18
Brief Summary
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Detailed Description
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Experiments will be performed on 2 groups of subjects 1) Normal kidney function (eGFR\>90) 2) Stage 2-3 CKD (eGFR 30-89). VAsoactive medications will be held for 72 hours before study. All participants will attend a baseline study visit, which will include a physical examination, a medical history review, vital sign measurements, and blood collection. Muscle nerve activity and muscle oxygenation will be measured while the subjects perform hand grip exercise at 30% maximum voluntary contraction with and without lower body negative pressure (- 20 mmHg). Muscle blood flow will be measured before and after hand grip exercises. CKD subjects will then be randomized to exercise training (to squeeze a tennis ball repeatedly for at least 30 min/day) or no exercise training for 28 days. Procedures in baseline visit will be repeated followed by cross over to alternate group for 28 days followed by repeat of baseline procedures. Blood flow, muscle oxygenation and muscle nerve activity will be compared between CKD and normal subjects as well as before and after exercise training for CKD subjects.
Conditions
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Study Design
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RANDOMIZED
CROSSOVER
PREVENTION
NONE
Study Groups
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Exercise training followed by no exercise training
CKD subjects will be randomized to exercise training (to squeeze a tennis ball repeatedly for at least 30 min/day) or no exercise training for 28 days. Procedures in baseline visit will be repeated followed by cross over to alternate group for 28 days followed by repeat of baseline procedures.
Forearm exercise training
Subjects will be asked to squeeze a tennis ball repeatedly for at least 30 min/day for 28 days at an approximate rate of 20 squeezes/min.
No exercise training followed by exercise training
CKD subjects will be randomized to exercise training (to squeeze a tennis ball repeatedly for at least 30 min/day) or no exercise training for 28 days. Procedures in baseline visit will be repeated followed by cross over to alternate group for 28 days followed by repeat of baseline procedures.
Forearm exercise training
Subjects will be asked to squeeze a tennis ball repeatedly for at least 30 min/day for 28 days at an approximate rate of 20 squeezes/min.
Normal Control
Control subjects without CKD will undergo baseline assessment as above.
No interventions assigned to this group
Interventions
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Forearm exercise training
Subjects will be asked to squeeze a tennis ball repeatedly for at least 30 min/day for 28 days at an approximate rate of 20 squeezes/min.
Eligibility Criteria
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Inclusion Criteria
* CKD 2-3
Exclusion Criteria
* eGFR \>60ml/min/1.73 m2 or eGFR \<30ml/min/1.73 m2
* Any evidence of cardiopulmonary disease, left ventricular hypertrophy or systolic dysfunction by echocardiography.
* Diabetes mellitus or other systemic illness
* Pregnancy
* Any history of substance abuse or current cigarette use
* Any history of psychiatric illness
* History of malignancy
18 Years
ALL
Yes
Sponsors
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University of Texas Southwestern Medical Center
OTHER
Responsible Party
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Wanpen Vongpatanasin
Professor
Principal Investigators
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Wanpen Vongpatanasin, MD
Role: PRINCIPAL_INVESTIGATOR
UT Southwestern Medical Center
Locations
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University of Texas Southwestern Medical Center at Dallas
Dallas, Texas, United States
Countries
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References
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Moore GE, Painter PL, Brinker KR, Stray-Gundersen J, Mitchell JH. Cardiovascular response to submaximal stationary cycling during hemodialysis. Am J Kidney Dis. 1998 Apr;31(4):631-7. doi: 10.1053/ajkd.1998.v31.pm9531179.
Adams GR, Vaziri ND. Skeletal muscle dysfunction in chronic renal failure: effects of exercise. Am J Physiol Renal Physiol. 2006 Apr;290(4):F753-61. doi: 10.1152/ajprenal.00296.2005.
Paglialonga F, Lopopolo A, Scarfia RV, Galli MA, Consolo S, Brivio A, Grassi MR, Salera S, Edefonti A. Correlates of exercise capacity in pediatric patients on chronic hemodialysis. J Ren Nutr. 2013 Sep;23(5):380-6. doi: 10.1053/j.jrn.2013.04.006. Epub 2013 Jun 22.
Bradley JR, Anderson JR, Evans DB, Cowley AJ. Impaired nutritive skeletal muscle blood flow in patients with chronic renal failure. Clin Sci (Lond). 1990 Sep;79(3):239-45. doi: 10.1042/cs0790239.
Sakkas GK, Ball D, Mercer TH, Sargeant AJ, Tolfrey K, Naish PF. Atrophy of non-locomotor muscle in patients with end-stage renal failure. Nephrol Dial Transplant. 2003 Oct;18(10):2074-81. doi: 10.1093/ndt/gfg325.
Hansen J, Sander M, Thomas GD. Metabolic modulation of sympathetic vasoconstriction in exercising skeletal muscle. Acta Physiol Scand. 2000 Apr;168(4):489-503. doi: 10.1046/j.1365-201x.2000.00701.x.
Vongpatanasin W, Wang Z, Arbique D, Arbique G, Adams-Huet B, Mitchell JH, Victor RG, Thomas GD. Functional sympatholysis is impaired in hypertensive humans. J Physiol. 2011 Mar 1;589(Pt 5):1209-20. doi: 10.1113/jphysiol.2010.203026. Epub 2011 Jan 4.
Mizuno M, Iwamoto GA, Vongpatanasin W, Mitchell JH, Smith SA. Exercise training improves functional sympatholysis in spontaneously hypertensive rats through a nitric oxide-dependent mechanism. Am J Physiol Heart Circ Physiol. 2014 Jul 15;307(2):H242-51. doi: 10.1152/ajpheart.00103.2014. Epub 2014 May 9.
Piantadosi CA, Hemstreet TM, Jobsis-Vandervliet FF. Near-infrared spectrophotometric monitoring of oxygen distribution to intact brain and skeletal muscle tissues. Crit Care Med. 1986 Aug;14(8):698-706. doi: 10.1097/00003246-198608000-00007.
Kumar S, Seward J, Wilcox A, Torella F. Influence of muscle training on resting blood flow and forearm vessel diameter in patients with chronic renal failure. Br J Surg. 2010 Jun;97(6):835-8. doi: 10.1002/bjs.7004.
Other Identifiers
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STU 092015-005
Identifier Type: -
Identifier Source: org_study_id
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