Kidney Week

Abstract: SA-PO359

Cardiovascular Functional Capacity in Patients with CKD: Insights from the FIT-INDY Study

Session Information

• Hypertension, CVD, and the Kidneys: Clinical Research
  October 26, 2024 | Location: Exhibit Hall, Convention Center
  Abstract Time: 10:00 AM - 12:00 PM

Category: Hypertension and CVD

• 1602 Hypertension and CVD: Clinical

Authors

• Groninger, Nolan, Indiana University School of Medicine, Indianapolis, Indiana, United States

Nolan Groninger

• Samanani, Nikita Firozali, Indiana University School of Medicine, Indianapolis, Indiana, United States

Nikita Firozali Samanani, MS

• Altherr, Cody A., Indiana Center for Musculoskeletal Health, Indianapolis, Indiana, United States

Cody A. Altherr, MS

• Narayanan, Gayatri, Indiana University School of Medicine, Indianapolis, Indiana, United States

Gayatri Narayanan, MS

• Lim, Kenneth, Indiana University School of Medicine, Indianapolis, Indiana, United States

Kenneth Lim, MD, PhD, FASN

Background

Patients with chronic kidney disease (CKD) exhibit a significantly increased risk of cardiovascular disease beginning in the early stages of kidney impairment. However, whether cardiovascular functional capacity is reduced in early-stage CKD and the pattern of its impairment is largely unknown. The goal of this study was to evaluate the natural history of impairment in cardiovascular functional capacity (by VO₂Peak) as assessed by Cardiopulmonary Exercise Testing (CPET) in patients with early-stage CKD.

Methods

We analyzed data from 139 patients in the ongoing Cardiorespiratory Fitness in Patients with Chronic Kidney Disease in Indiana (FIT-INDY) Study, an ambulatory referral cohort of patients who have undergone CPET as part of their standard of care from 2005 to 2023. Participants were stratified into three groups by estimated Glomerular Filtration Rate (eGFR): eGFR ≥90 (n=79); eGFR 60-89 (n=40); and eGFR <60 (n=20). Associations between eGFR and VO₂Peak were assessed using multiple linear regression modeling.

Results

Patients in the lowest eGFR group <60 (62 [45-71] y) were significantly older compared with the other groups (eGFR 60-89=47 [38-56] y; eGFR ≥90=36 [27-44] y; P<0.001). No significant differences in sex were observed between groups. We report an incremental impairment in VO₂Peak observed with declining kidney function (eGFR ≥90, 21.0 [14.8-26.2] mL/min/kg; eGFR 60-89, 16.2 [12.7-19.5] mL/min/kg; eGFR<60, 12.0 [8.8-13.2] mL/min/kg). Additionally, maximal workload declined serially with declining kidney function (eGFR ≥90, 120.0±49.6 W; eGFR 60-89, 117.0±48.8 W; eGFR<60, 70.9±19.7 W; P=0.002). After adjusting for age and hemoglobin, the relationship between eGFR and VO₂Peak remained significant (P=0.017).

Conclusion

Our study highlights that patients with mild to moderate CKD exhibit impaired cardiovascular functional capacity. These findings emphasize the importance of early cardiovascular assessment and management in individuals with CKD, and the need for further studies examining cardiovascular functional alterations in patients with kidney failure.

Funding

• Other NIH Support