What Maintains the Metabolic Cost at Peak Aerobic Exercise in End Stage Renal Disease Patients
2017
Background: End-stage renal disease (ESRD) reduces performance of cardiopulmonary function and peak
oxygen uptake (VO2 peak). The possible roles of oxygen delivery and oxygen extraction as limiting factors of exercise
tolerance in ESRD patients were assessed.
Methods: A cross-sectional study was conducted with twenty-two ESRD patients who underwent a peak
cardiopulmonary and echocardiograph exercise test via leg cycle ergometry.
Results: During exercise, elevated lactic acid occurred at a mean workload of 68.6 ± 5.7 Watts, corresponding
to 78% of their respective peak work capacity. At peak exercise, in all measured variables except for systolic blood
pressure, ESRD patients did not achieve normally predicted values. Heart rate, left ventricular end diastolic and
systolic volumes, stroke volume, cardiac output, VO2 peak, arteriovenous oxygen difference, and workload were
below normal values, while diastolic blood pressure, mean blood pressure and total peripheral resistance were
above normal values.
Conclusions: In ESRD patients, values for both oxygen delivery and extraction were far below the recorded
values in normal. This suggests diminished central cardiopulmonary responses as well as reduced peripheral
capacity to extract oxygen at the muscle level. Findings support the concept and possible importance of exercise
rehabilitation programs in the approach for treatment of ESRD patients.
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