Kotoku Kazuko, Yasuno Tetsuhiko, Kawakami Shotaro, Fujimi Kanta, Matsuda Takuro, Nakashima Shihoko, Uehara Yoshinari, Tanaka Hiroaki, Saito Takao, Higaki Yasuki
Graduate School of Sports and Health Science, Fukuoka University, 8-19-1 Nanakuma, Johnan-ku, Fukuoka, 814-0180, Japan.
Faculty of Medicine and Health Science, Yamaguchi University, 1-1-1, Minamiogushi, Ube, Yamaguchi, 755-8505, Japan.
Clin Exp Nephrol. 2019 May;23(5):621-628. doi: 10.1007/s10157-018-01685-3. Epub 2019 Feb 7.
Acute exercise reduces renal blood flow (RBF). However, the effect of exercise intensity on RBF in patients with chronic kidney disease (CKD) stage 2 is not known. We investigated the association between RBF and exercise intensity in patients with CKD stage 2 using pulsed Doppler ultrasonography.
Eight men with CKD stage 2 (cystatin C-based estimate of glomerular filtration rate: 60-89 ml/min/1.73 m) participated in this study. Using a bicycle ergometer, participants undertook a maximal graded exercise test (MGET) (experiment 1) and a multi-stage exercise test (experiment 2) to determine their lactate threshold (LT). Participants undertook a multi-stage exercise test for 4-min each. Workloads of 60%, 80%, 100%, 120%, and 140% of LT were used in experiment 3. RBF was measured by pulsed Doppler ultrasonography at rest, immediately after exercise, and 1 h after exercise in experiment 1, and at rest and immediately after each exercise bout in experiment 3.
Renal blood flow after the MGET was 52% lower than at rest, and did not recover as well as after the exercise test. Cross-sectional area (CSA) was significantly lower after graded exercise. RBF tended to be lower at 100% of LT and was significantly lower at 120% of LT. CSA was significantly lower at 100% of LT.
Renal blood flow does not change during exercise until the LT is reached. These findings may assist in making appropriate exercise recommendations to patients with CKD stage 2.
急性运动可减少肾血流量（RBF）。然而，运动强度对2期慢性肾脏病（CKD）患者肾血流量的影响尚不清楚。我们使用脉冲多普勒超声检查，研究了2期CKD患者肾血流量与运动强度之间的关联。
八名2期CKD男性患者（基于胱抑素C估算的肾小球滤过率：60 - 89 ml/min/1.73 m²）参与了本研究。参与者使用自行车测力计进行了最大分级运动试验（MGET）（实验1）和多级运动试验（实验2），以确定其乳酸阈值（LT）。参与者每次进行4分钟的多级运动试验。实验3中使用了相当于LT的60%、80%、100%、120%和140%的工作量。在实验1中，于静息状态、运动后即刻和运动后1小时，以及在实验3中于静息状态和每次运动回合后即刻，通过脉冲多普勒超声测量肾血流量。
MGET后的肾血流量比静息时低52%，且恢复情况不如运动试验后。分级运动后横截面积（CSA）显著降低。在相当于LT的100%时肾血流量趋于降低，在相当于LT的120%时显著降低。在相当于LT的100%时CSA显著降低。
在达到乳酸阈值之前，运动期间肾血流量不变。这些发现可能有助于为2期CKD患者制定合适的运动建议。
