Kidney Week

Abstract: FR-OR31

Home-Based Exercise Improves Muscle Mitochondrial Function in CKD: Results from a Pilot Randomized, Controlled Clinical Trial

Session Information

• Exercise and Kidney Health: From Bench to Smartphone
  October 25, 2024 | Location: Room 4, Convention Center
  Abstract Time: 05:00 PM - 05:10 PM

Category: Health Maintenance, Nutrition, and Metabolism

• 1500 Health Maintenance, Nutrition, and Metabolism

Authors

• Hayden, Christopher, University of California Davis, Davis, California, United States

Christopher Hayden, MS

• Begue, Gwenaelle, California State University Sacramento, Sacramento, California, United States

Gwenaelle Begue, PhD

• Rehman, Usman, University of California Davis, Davis, California, United States

Usman Rehman

• Ahmadi, Armin, University of California Davis, Davis, California, United States

Armin Ahmadi, PhD

• Vargas, Chenoa R., University of California Davis, Davis, California, United States

Chenoa R. Vargas

• Jue, Thomas, University of California Davis, Davis, California, United States

Thomas Jue, PhD

• Gamboa, Jorge, Vanderbilt University School of Medicine, Nashville, Tennessee, United States

Jorge Gamboa, MD, PhD

• Roshanravan, Baback, University of California Davis School of Medicine, Sacramento, California, United States

Baback Roshanravan, MD, MS, MPH, FASN

Background

Chronic kidney disease (CKD) leads to impaired muscle mitochondrial function contributing to mobility impairment and frailty. Exercise training improves muscle function and physical capacity, but proper equipment and instruction can be difficult to access. We tested the impact of home-based exercise on in vivo muscle mitochondrial function.

Methods

We conducted a pilot randomized controlled trial (NCT02923063) of a 12 wk home-based, virtually supervised exercise (EX) in CKD sedentary patients compared to usual care (UC). Exercise consisted of one high-intensity interval training, one resistance training, and one power walking session per week. Primary endpoint was leg muscle oxidative capacity measured using ³¹Phosphorus Magnetic Resonance Spectroscopy. Participants performed one knee extension per second against an elastic resistance band for 42s depleting phosphocreatine (PCr) by 25-50%. PCr recovery was measured and fit with a monoexponential equation. The rate constant of this equation (kPCr, min^-1) is an indicator of mitochondrial oxidative capacity. Linear mixed models were used to test the effect of exercise on kPCr.

Results

Muscle oxidative capacity was 1.23±0.33min^-1 in UC (n=9, mean±SD age=67 ± 8yr, eGFR=32±12, 22% male, 44% diabetic) and 1.24±0.26 in EX (n=21, mean age=63.0±10yr, eGFR=35±12, 47% male, 47% diabetic) at baseline. Home-based exercise improved muscle oxidative capacity by 0.197min^-1 (95% CI: 0.05-0.35, P=0.01) compared to usual care (Fig 1).

Conclusion

Twelve weeks of virtually supervised at-home training can improve muscle oxidative capacity in CKD patients. These results support the use of exercise to combat mitochondrial dysfunction in CKD and demonstrate the efficacy of a low barrier to access intervention.

Funding

• NIDDK Support