Relationship of glomerular filtration rate and serum CK activity after resistance exercise in women

Impact of resistance exercise on patients with chronic kidney disease

BACKGROUND

Chronic kidney disease (CKD) has become an increasingly important public health disease with a high incidence rate and mortality. Although several studies have explored the effectiveness of resistance exercise in improving the prognosis of CKD patients, the number of studies is still limited and the results are still controversial.

OBJECTIVES

We conducted this meta-analysis of randomized controlled trials (RCT) studies to evaluate the effectiveness of resistance exercise on CKD patients.

METHODS

The PubMed, Embase, and Cochrane Library databases were searched from the inception date to October 2023. The meta-analysis was conducted to evaluate 12 main indicators, including glomerular filtration rate (GFR)(ml/(min•1.73m2)), C-reactive protein (CRP) (mg/L), serum creatinine (mg/dL), hemoglobin (g/dL), Glycosylated Hemoglobin, Type A1C (HBA1c) (%), high Density Lipoprotein (HDL) (mg/dL), low Density Lipoprotein (LDL) (mg/dL), 6-min walk(m), body mass index (BMI) (kg/m2), fat-free mass (kg), fat mass (kg), grip strength (kgf).

RESULTS

Sixteen RCT studies were included in this meta-analysis from 875 records. GFR exhibited no significant change in CKD patients treated with resistance exercise (WMD 1.82; 95%CI -0.59 to 4.23; P = 0.139). However, 6-min walk (WMD 89.93; 95%CI 50.12 to 129.74; P = 0.000), fat-free mass (WMD 6.53; 95%CI 1.14 to 11.93; P = 0.018) and grip strength (WMD 3.97; 95%CI 1.89 to 6.05; P = 0.000) were significantly improved with resistance exercise. The level of CRP (WMD - 2.46; 95%CI -4.21 to -0.72; P = 0.006) and HBA1c (WMD - 0.46; 95%CI -0.63 to -0.29; P = 0.000) dropped significantly after resistance exercise treatment.

CONCLUSIONS

Resistance exercise can improve physical function, metabolic condition, inflammatory response and cardiopulmonary function in CKD patients, specifically reflected in the increase of indicators fat-free mass, grip strength, 6-min walk, as well as the decrease of indicators HBA1c and CRP.

Association between Duration of Exercise (MET Hours per Week) and the Risk of Decreased eGFR: A Cross-Sectional Study Based on a Large Chinese Population

BACKGROUND

Physical activity is effective in preventing chronic diseases. However, the impact of different durations of exercise on human health is unknown, especially among people with diabetes or prediabetes.

OBJECTIVE

To explore the relationship between high MET hours per week and the change in glomerular filtration rate (eGFR) in the total population and different subgroups.

METHODS

A total of 43767 individuals from eight provinces, in China, were recruited. Logistic analysis was used to investigate the association. Participants were divided into 3 groups based on MET hours per week. The primary outcome was an eGFR ≤ 90 mL/min/1.73 m².

RESULTS

The average eGFR was 100.10 (92.43-106.43) mL/min/1.73². Logistic regression analysis revealed that more than 7.5 MET hours per week (equivalent to more than 150 minutes of moderate-intensity of exercise) was associated with the higher risk of the decreased eGFR even after adjusting for confounding factors (7.5 to <21: OR = 1.18, 95% CI [1.09, 1.29]; ≥21: OR = 1.12, 95% CI [1.05, 1.19], p for trend: 0.0047). After adjusting for confounding factors, in stratified analyses, there still existed a significant relationship among participants aged from 55 to less than 65 years, but not among participants younger than 55 or older than 65 years. Similarly, there existed a positive association between high MET hours per week and the decreased eGFR in participants without diabetes and prediabetes, but not in participants with diabetes or prediabetes, and the interactions of age and diabetic states were found. However, there was no significant difference in women or men.

CONCLUSIONS

More than 7.5 MET hours per week (equivalent to more than 150 minutes per week or 60 minutes per day of moderate-intensity exercise) was associated with decreased eGFR among participants aged from 55 to less than 65 years and participants without diabetes and prediabetes, but not among participants aged younger than 55 years and older than 65 years and participants with diabetes or prediabetes. The importance of planning individualized physical activities is highlighted.

Cardiopulmonary Performance During Maximal Exercise in Soccer Players with Alterations in Renal Function

The aim of this study was to evaluate the curves of cardiorespiratory variables during cardiopulmonary exercise testing (CPET) in soccer players who had acute alterations in the glomerular filtration rate (GFR) after performing the pre-season training protocol. Sixteen male professional soccer players (25 ± 3 years; 179 ± 2 cm; and 77 ± 6 kg) were evaluated for oxygen uptake (VO₂), heart rate (HR) and pulse relative oxygen (relative O₂ Pulse) curves with intervals corresponding to 10% of the total duration of CPET. Athletes were grouped according to the GFR and classified as decreased GFR (dGFR; n = 8) and normal GFR (nGFR; n = 8). Athletes from the dGFR group exhibited lower VO₂ values (p < 0.05) when 90% (dGFR 49.8 ± 4.0 vs. nGFR 54.4 ± 6.1 ml·kg^-1·min^-1) and 100% (dGFR 52.6 ± 4.1 vs. nGFR 57.4 ± 5.9 ml·kg^-1·min^-1) of the test was complete; HR high values (p < 0.05) when 90% (dGFR 183.7 ± 5.1 vs. nGFR 176.6 ± 4.8 bpm-1) and 100% (dGFR 188.1 ± 5.0 vs. nGFR 180.8 ± 4.8 bpm-1) of the test was complete; and lower relative O₂ Pulse values (p < 0.05) when 70% (dGFR 25.6 ± 8.4 vs. nGFR 27.9 ± 9.7 ml·beat^-1·kg^-1), 80% (dGFR 26.6 ± 8.8 vs. nGFR 29.1 ± 10.0 ml·beat^-1·kg^-1), 90% (dGFR 27.1 ± 9.0 vs. nGFR 30.8 ± 10.6 ml·beat^-1·kg^-1) and 100% (dGFR 28 ± 9.2 vs. nGFR 31.8 ± 10.9 ml·beat^-1·kg^-1) of the test was complete. A correlation was found (r = −0.66, R² = 0.44, p = 0.00) between lower VO₂ peak and elevated levels of urinary protein excretion. In conclusion, soccer players with reduced kidney function after performing the pre-season training protocol also presented alterations in cardiopulmonary variables. We suggest that monitoring of renal function may be used to identify less conditioned soccer players.

Sex differences in serum CK activity but not in glomerular filtration rate after resistance exercise: is there a sex dependent renal adaptative response?

We investigated differences in sex responses in serum CK activity and renal function measured by glomerular filtration rate (GFR) after an exercise session. Twenty-two healthy and trained volunteers (11 males and 11 females) performed 17 resistance exercises with 3 × 12 repetitions in a circuit training fashion. Subjects provided blood samples prior to exercise session, and at 24, 48, and 72 h following exercise sessions for creatine kinase and creatinine. Twenty-four-hour urine samples were collected before and 72 h after the exercise. Estimate (e) GFR was obtained by using the Chronic Kidney Disease Epidemiology Collaboration equation adjusted for males and females. After the exercise session, males showed greater serum CK activity than females (p < 0.02), serum creatinine increased 31.3 % for males and 29.8 % for females, and urinary creatinine decreased on average 5.4 % for males and 0.6 % for females, with no significant differences (p > 0.05) between sex for serum and urinary creatinine. eGFR decreased significantly for males (~10 %) and females (~8 %), but also without a difference between the sexes (p > 0.05). The correlation between CK and eGFR was significant for males (r = -0.794; p = 0.003), and females (r = -0.8875; p < 0.001). A significant negative correlation between CK activity and the eGFR indice of renal function in both males and females was observed. Additionally, the renal function compromise was similar for both sexes, despite males presenting greater exercise-induced skeletal muscle damage when compared to females.

Glomerular filtration rate after a 12-wk resistance exercise program with post-exercise protein ingestion in community dwelling elderly

OBJECTIVE

Increased protein intake and resistance exercise can be beneficial for maintenance of lean body mass (LBM) in older adults. However, these factors could also negatively affect renal function. We investigated changes in renal function after a 12-wk resistance exercise program combined with protein supplementation in community dwelling older adults.

METHODS

Patients (N = 237, 73.7 ± 5.7 y, 58.2% female) participated in a 12-wk resistance exercise program (3 times/wk) designed to increase strength and muscle mass of major muscle groups. Participants were randomly assigned to one of three dietary supplements consumed directly after training: whey protein drink (20 g whey protein, 20 g carbohydrates), milk protein drink (20 g milk protein, 20 g carbohydrates), or carbohydrate drink (40 g carbohydrates). Renal function was estimated as glomerular filtration rate (GFR, Cockcroft-Gault formula), and dietary intake was measured as 3-d-weighed food record at baseline and endpoint.

RESULTS

During the intervention, energy intake did not increase. Carbohydrate intake increased in the carbohydrate group and protein intake increased in the milk group, both approximately in accordance with the supplementation. In the whey group, protein intake did not increase, but carbohydrate intake did. GFR increased after the intervention (+4.4 mL/min/1.73 m2; P < 0.001), and the changes were similar in men and women or in the age quartiles. Changes in GFR at endpoint were not associated with LBM, dietary supplements, or total protein intake.

CONCLUSIONS

A 12-wk resistance exercise program combined with protein supplementation in community dwelling older adults does not negatively affect GFR. The supplementation had only minor effects on total dietary intake.

Serum creatine kinase activity and its relationship with renal function indices in professional cyclists during the Giro d'Italia 3-week stage race

OBJECTIVE

To analyze the behavior of total creatine kinase (CK) and other muscular damage markers and to compare CK activity and renal function indices in professional cyclists during a 3-week stage race.

DESIGN

Prospective, noncomparative, interventional.

SETTING

The athletes were recruited during the 2011 Giro d'Italia.

PARTICIPANTS

Nine professional road cyclists from the Liquigas-Cannondale team and competing in the race.

ASSESSMENT OF RISK FACTORS

Blood samples were collected on the day before the start of the race, on day 12, and on the final day (day 22) of the race.

MAIN OUTCOME MEASURES

: Creatinine and cystatin C concentrations, CK, lactate dehydrogenase (LDH), and aspartate aminotransferase (AST) activities were measured. The estimated glomerular filtration rate was calculated according to equations based on creatinine, cystatin C, or both.

RESULTS

Creatine kinase and AST activity increased during the second part of the race, and LDH activity progressively increased during the entire course of the race. There was a negative correlation between CK activity and the delta prerace-day 12 of glomerular filtration rate, as obtained with simple cystatin C or with Chronic Kidney Disease Epidemiology Collaboration (CKD-EPI) creatinine and cystatin C equations.

CONCLUSIONS

The effect of prolonged strenuous muscular effort on biochemical laboratory parameters in professional road cyclists was confirmed. The correlation observed between renal function and CK activity underscores that measurement of cystatin C is more accurate than creatinine alone in the evaluation of renal function and that it is unaffected by response to physical stress-induced muscular damage.