Key result
Twelve months of balance or strength training combined with endurance training did not prevent the progression of abdominal aortic calcification in patients with non-dialysis dependent chronic kidney disease.
Why the study?
Arteriosclerosis is prevalent in patients with CKD, but the effects of balance or strength training combined with endurance training on abdominal aortic calcification and related markers remained unknown.
Does 12 months of exercise training (balance or strength combined with endurance) prevent the progression of abdominal aortic calcification in non-dialysis dependent patients with CKD stages 3 to 5?
RCT (n=112)
Single-blind
SAS ProcPlan
No
Does 12 months of exercise training (balance or strength combined with endurance) prevent the progression of abdominal aortic calcification in non-dialysis dependent patients with CKD stages 3 to 5?
Absolute Event Rate: 1% vs 1%
Twelve months of exercise training did not halt the progression of abdominal aortic calcification in patients with non-dialysis dependent CKD, though it may have contributed to reduced lipoprotein (a) levels.
Exercise does not slow AAC progression in CKD stages 3-5; challenges assumptions that combined training modifies vascular calcification.
Background Arteriosclerosis is prevalent in patients with chronic kidney disease (CKD). Our aims were to investigate (1) the effects of 12 months of either balance- or strength- both in combination with endurance training on abdominal aortic calcification (AAC); on some lipids and calcific- and inflammatory markers; and (2) the relationships between the change in AAC score and these markers in non-dialysis dependent patients with CKD stages 3 to 5. Methods One hundred twelve patients (mean age 67 ± 13 years), who completed 12 months of exercise training; comprising either balance- or strength training, both in combination with endurance training; with a measured glomerular filtration rate (mGFR) 22.6 ± 8 mL/min/1.73m 2 , were included in this study. AAC was evaluated with lateral lumbar X-ray using the scoring system described by Kauppila. Plasma fetuin-A, fibroblast growth factor 23 (FGF23) and interleukin 6 (IL6) were measured with Enzyme-linked immunosorbent assay (ELISA) kits. Results After 12 months of exercise training, the AAC score increased significantly in both groups; mGFR and lipoprotein (a) decreased significantly in both groups; parathyroid hormone (PTH) and 1,25(OH) 2 D 3 increased significantly only in the strength group; fetuin-A increased significantly only in the balance group. Plasma triglycerides, total cholesterol, high-density lipoprotein cholesterol, low-density lipoprotein cholesterol, FGF23, phosphate, calcium, IL6, C-reactive protein (CRP), albumin were unchanged. The increase in AAC score was positively related to ageing and the levels of baseline triglycerides and lipoprotein (a). Conclusions Exercise training did not prevent the progression of AAC; it might have contributed to the reduced levels of lipoprotein (a) and unchanged levels of calcific- and inflammatory markers in these patients with non-dialysis dependent CKD. Hypertriglyceridemia, high levels of lipoprotein (a) and ageing emerged as longitudinal predictors of vascular calcification in these patients. Trial registration NCT02041156 at www.ClinicalTrials.gov. Date of registration: January 20, 2014. Retrospectively registered.
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Zhou et al. (2020) conducted an RCT in Chronic kidney disease (CKD) stages 3 to 5 (n=112). Balance training combined with endurance training vs. Strength training combined with endurance training was evaluated on Increase in abdominal aortic calcification (AAC) score at 12 months. Twelve months of balance or strength training combined with endurance training did not prevent the progression of abdominal aortic calcification in patients with non-dialysis dependent chronic kidney disease.
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