Kidney Week

Abstract: TH-PO798

The Effect of Long-Term High-Intensity Interval Training on CKD Prevention in the Elderly: A Substudy of the Generation-100 Randomized Controlled Trial

Session Information

• Voices, Choices, and Outcomes of Older Adults with CKD
  November 03, 2022 | Location: Exhibit Hall, Orange County Convention Center‚ West Building
  Abstract Time: 10:00 AM - 12:00 PM

Category: Geriatric Nephrology

• 1200 Geriatric Nephrology

Authors

• Hallan, Stein I., Norges teknisk-naturvitenskapelige universitet, Trondheim, Trøndelag, Norway

Stein I. Hallan,

• Øvrehus, Marius Altern, St Olavs Hospital Universitetssykehuset i Trondheim, Trondheim, Trøndelag, Norway

Marius Altern Øvrehus,

• Shlipak, Michael, University of California San Francisco, San Francisco, California, United States

Michael Shlipak,

• Ix, Joachim H., University of California San Diego, La Jolla, California, United States

Joachim H. Ix,

• Stensvold, Dorthe, Norges teknisk-naturvitenskapelige universitet, Trondheim, Trøndelag, Norway

Dorthe Stensvold,

• Langlo, Knut Asbjørn Rise, Norges teknisk-naturvitenskapelige universitet, Trondheim, Trøndelag, Norway

Knut Asbjørn Rise Langlo,

Background

Recent trials suggest moderate-intensity exercise may lower CKD incidence in older adults. Whether or not there is a dose response relationship regarding intensity of exercise and CKD risk is unknown. High-intensity interval training (HIIT) has shown very encouraging results on cardiorespiratory capacity, endothelial function and other key aspects of cardiovascular as well as kidney health.

Methods

All inhabitants of Trondheim, Norway, aged 70-77 years were invited to participate in the Generation 100 study. Main exclusion criteria were uncontrolled hypertension, unstable angina, heart failure or symptomatic valvular disease, dementia, cancer or other diseases or disabilities that precluded exercise. Participants were randomized to supervised physical training consisting of 10-minute warm-up followed by 4×4-minute high-intensity interval training (HIIT) at ~90% of peak heart rate or 50 minutes of moderate-intensity continuous training (MICT) at ~70% of peak heart rate twice/week for five years. Peak oxygen uptake (VO₂ peak) and blood samples were obtained at baseline and at one, three, and five years. Incident CKD was defined as a >25% eGFR decline to a new level <60ml/min/1.73m² based on the CKD-EPI Cystatin C equation.

Results

The 787 participants had mean (1 SD) age 72 (2) years, 51% were males, and 6% had diabetes. Baseline blood pressure was 134 (18) / 75 (9) mmHg, and eGFR was 91 (16) ml/min/1.73m². In total, 400 subjects were randomized to the HIIT group and 387 to the MICT groups. After one year, mean VO₂ peak had increased from 28.9 (6.4) to 32.2 (6.7) ml/kg/min in the HIIT group and from 28.6 (6.6) to 30.9 (6.8) ml/kg/min in the MICT group. During the five-year training period, there were 13 new CKD cases in the HIIT group (3.4%) and 25 cases in the MICT group (6.7%) for a relative risk reduction of 0.47 (95% CI 0.24, 0.93, p=0.030). There was no interaction between the HIIT treatment effect and baseline levels of VO₂ peak or eGFR.

Conclusion

Among older persons, compared to moderate-intensity continuous training, high-intensity interval training reduced the risk of incident CKD.

Funding

• Government Support – Non-U.S.