Publication:
Metabolic effects of diet and exercise in patients with moderate to severe CKD: A randomized clinical trial

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Issued Date

2018

Resource Type

Article

File Type

application/pdf

ISSN

10466673

DOI

10.1681/ASN.2017010020

Other identifier(s)

2-s2.0-85040117215

Rights Holder(s)

Scopus

Bibliographic Citation

Journal of the American Society of Nephrology. Vol 29, No.1 (2018), p.250-259

Suggested Citation

Alp Ikizler T., Robinson-Cohen C., Ellis C., Headley S.A.E., Tuttle K., Wood R.J., Evans E.E., Milch C.M., Moody K.A., Germain M., Limkunakul C., Bian A., Stewart T.G., Himmelfarb J. Metabolic effects of diet and exercise in patients with moderate to severe CKD: A randomized clinical trial. Journal of the American Society of Nephrology. Vol 29, No.1 (2018), p.250-259. doi:10.1681/ASN.2017010020 Retrieved from: https://hdl.handle.net/20.500.14740/3939

Title

Metabolic effects of diet and exercise in patients with moderate to severe CKD: A randomized clinical trial

Author(s)

Alp Ikizler T.
 Robinson-Cohen C.
 Ellis C.
 Headley S.A.E.
 Tuttle K.
 Wood R.J.
 Evans E.E.
 Milch C.M.
 Moody K.A.
 Germain M.
 Limkunakul C.
 Bian A.
 Stewart T.G.
 Himmelfarb J.

Abstract

CKD is steadily increasing along with obesity worldwide. Furthermore, obesity is a proinflammatory risk factor for progression of CKD and cardiovascular disease. We tested the hypothesis that implementation of caloric restriction and aerobic exercise is feasible and can improve the proinflammatory metabolic milieu in patients with moderate to severe CKD through a pilot, randomized, 232 factorial design trial. Of 122 participants consented, 111 were randomized to receive caloric restriction and aerobic exercise, caloric restriction alone, aerobic exercise alone, or usual care. Of those randomized, 42% were women, 25% were diabetic, and 91% were hypertensive; 104 started intervention, and 92 completed the 4-month study. Primary outcomes were a change from baseline in absolute fat mass, body weight, plasma F2-isoprostane concentrations, and peak oxygen uptake (VO2 peak). Compared with usual care, the combined intervention led to statistically significant decreases in body weight and body fat percentage. Caloric restriction alone also led to significant decreases in these measures, but aerobic exercise alone did not. The combined intervention and each independent intervention also led to significant decreases in F2-isoprostane and IL-6 concentrations. No intervention produced significant changes in VO2 peak, kidney function, or urine albumin-to-creatinine ratio. In conclusion, 4-month dietary calorie restriction and aerobic exercise had significant, albeit clinically modest, benefits on body weight, fat mass, and markers of oxidative stress and inflammatory response in patients with moderate to severe CKD. These results suggest healthy lifestyle interventions as a nonpharmacologic strategy to improve markers of metabolic health in these patients. Copyright © 2018 by the American Society of Nephrology.

Subject(s)

Albumin
 Creatinine
 Interleukin 6
 Isoprostane derivative
 Oxygen
 Creatinine
 IL6 protein, human
 Interleukin 6
 Isoprostane derivative
 Adult
 Aerobic exercise
 Aged
 Article
 Blood level
 Body weight
 Caloric restriction
 Chronic kidney failure
 Clinical outcome
 Controlled study
 Diabetes mellitus
 Fat mass
 Female
 Human
 Hypertension
 Major clinical study
 Male
 Oxygen consumption
 Pilot study
 Priority journal
 Randomized controlled trial
 Albuminuria
 Blood
 Chronic kidney failure
 Exercise
 Glomerulus filtration rate
 Middle aged
 Obesity
 Oxidative stress
 Pathophysiology
 Physiology
 Urine
 Adiposity
 Aged
 Albuminuria
 Body Weight
 Caloric Restriction
 Creatinine
 Exercise
 F2-Isoprostanes
 Female
 Glomerular Filtration Rate
 Humans
 Interleukin-6
 Male
 Middle Aged
 Oxidative Stress
 Oxygen Consumption
 Pilot Projects
 Renal Insufficiency, Chronic

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URI

https://hdl.handle.net/20.500.14740/3939

Collections

Scopus: Year 1983-2021

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