Impaired K+ regulation contributes to exercise limitation in end-stage renal failure

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Sangkabutra, Termboon, Crankshaw, David P, Schneider, Claudia, Fraser, Steve F, Sostaric, Simon, Mason, Kim, Burge, Caroline M, Skinner, Sandford L, McMahon, Lawrence P and McKenna, Michael ORCID: 0000-0001-9998-0093 (2003) Impaired K+ regulation contributes to exercise limitation in end-stage renal failure. Kidney international, 63 (1). pp. 283-290. ISSN 0085-2538

Abstract

BACKGROUND: Patients with end-stage renal failure (ESRF) exhibit grossly impaired maximal exercise performance. This study investigated whether K+ regulation during exercise is impaired in ESRF and whether this is related to reduced exercise performance. METHODS: Nine stable hemodialysis patients and eight controls (CON) performed incremental cycling exercise to volitional fatigue, with measurement of peak oxygen consumption (VO2 peak). Arterial blood was sampled during and following exercise and analyzed for plasma [K+] (PK). RESULTS: The VO2 peak was approximately 44% less in ESRF than in CON (P < 0.001), whereas peak exercise PK was greater (7.23 +/- 0.38 vs. 6.23 +/- 0.14 mmol x L-1, respectively, P < 0.001). In ESRF, the rate of rise in PK during exercise was twofold greater (0.43 +/- 0.05 vs. 0.23 +/- 0.03 mmol. L-1x min-1, P < 0.005) and the ratio of rise in PK relative to work performed was 3.7-fold higher (90.1 +/- 13.5 vs. 24.7 +/- 3.3 nmol. L-1. J-1, P < 0.001). A strong inverse relationship was found between VO2 peak and the DeltaPK. work-1 ratio (r = -0.80, N = 17, P < 0.001). CONCLUSIONS: Patients with ESRF exhibit grossly impaired extrarenal K+ regulation during exercise, demonstrated by an excessive rise in PK relative to work performed. We further show that K+ regulation during exercise was correlated with aerobic exercise performance. These results suggest that disturbed K+ regulation in ESRF contributes to early muscle fatigue during exercise, thus causing reduced exercise performance.

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Item type Article
URI https://vuir.vu.edu.au/id/eprint/1237
DOI https://doi.org/10.1046/j.1523-1755.2003.00739.x
Official URL http://dx.doi.org/10.1046/j.1523-1755.2003.00739.x
Subjects Historical > RFCD Classification > 320000 Medical and Health Sciences
Historical > RFCD Classification > 330000 Education
Historical > Faculty/School/Research Centre/Department > Centre for Ageing, Rehabilitation, Exercise & Sport Science (CARES)
Keywords exercise, kidney failure chronic metabolism, kidney failure chronic physiopathology, potassium blood, adult, exercise test, female, humans, kidney failure chronic therapy, male oxygen consumption, plasma volume, renal dialysis
Citations in Scopus 19 - View on Scopus
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