Santana Davi A, Poortmans Jacques R, Dórea Egidio Lima, Machado Juliana Bannwart de Andrade, Fernandes Alan Lins, Sá-Pinto Ana Lúcia, Gualano Bruno, Roschel Hamilton
Applied Physiology & Nutrition Research Group, School of Physical Education and Sport, University of São Paulo, São Paulo, Brazil.
Faculty of Medicine, Rheumatology Division, University of São Paulo, São Paulo, Brazil.
Am J Physiol Renal Physiol. 2017 Aug 1;313(2):F547-F552. doi: 10.1152/ajprenal.00131.2017. Epub 2017 May 17.
Exercise has been overlooked as a potential therapy in chronic kidney disease (CKD), mainly because of a lack of understanding on its safety aspects. Notably, there are no data on renal function after exercise in CKD considering its stages. We investigated the acute effects of a 30-min moderate-intensity aerobic exercise bout on glomerular filtration rate (GFR) and albuminuria in 22 nondialysis CKD patients divided into: CKD stages 1 and 2 (CKD) and CKD stages 3 and 4 (CKD). Eleven body mass index-, age-, and sex-matched healthy individuals served as control (CON). Blood and urine samples were collected before, immediately after, and up to 90 min postexercise for creatinine and albumin assessments. GFR was determined by creatinine clearance (GFR). All CKD patients had significantly lower peak oxygen uptake than CON. CKD and CKD had increasingly higher serum creatinine than CON (9.6 ± 2.6, 25.6 ± 1.01, and 7.5 ± 1.4 mg/l, respectively); however, no within-group changes in serum or urinary creatinine were observed across time. GFR was decreased in CKD and CKD compared with CON (91 ± 17 ml·min·1.73 m; 34 ± 15 ml·min·1.73 m; 122 ± 20 ml·min·1.73 m, respectively). Most importantly, exercise did not affect GFR in none of the groups across time. Albuminuria was significantly higher in CKD (297 ± 284 µg/min) than in CON (5.4 ± 1.4 µg/min), but no within-group changes were observed after exercise. In conclusion, a single 30-min moderate-intensity aerobic exercise bout does not impair renal function in nondialysis CKD patients, regardless of disease stage, supporting the notion that exercise training can be safe in this disease.
运动作为慢性肾脏病（CKD）的一种潜在治疗方法一直被忽视，主要是因为对其安全性缺乏了解。值得注意的是，关于CKD不同阶段运动后肾功能的数据尚无。我们调查了一次30分钟中等强度有氧运动对22例非透析CKD患者肾小球滤过率（GFR）和蛋白尿的急性影响，这些患者被分为：CKD 1期和2期（CKD1-2）以及CKD 3期和4期（CKD3-4）。11名体重指数、年龄和性别匹配的健康个体作为对照（CON）。在运动前、运动后即刻以及运动后90分钟内采集血液和尿液样本，用于评估肌酐和白蛋白。通过肌酐清除率（GFR）测定GFR。所有CKD患者的峰值摄氧量均显著低于CON组。CKD1-2组和CKD3-4组的血清肌酐水平均高于CON组（分别为9.6±2.6、25.6±1.01和7.5±1.4mg/l）；然而，各时间点组内血清或尿肌酐均未观察到变化。与CON组相比，CKD1-2组和CKD3-4组的GFR降低（分别为91±17ml·min·1.73m²；34±15ml·min·1.73m²；122±20ml·min·1.73m²）。最重要的是，运动在各时间点均未影响任何一组的GFR。CKD1-2组的蛋白尿（297±284μg/min）显著高于CON组（5.4±1.4μg/min），但运动后组内未观察到变化。总之，一次30分钟中等强度有氧运动不会损害非透析CKD患者的肾功能，无论疾病处于何阶段，这支持了运动训练在该疾病中可能是安全的这一观点。
