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Twelve months of exercise training did not halt abdominal aortic calcification in patients with CKD – a sub-study of RENEXC-a randomized controlled trial

  • Zhou, Yunan1
  • Hellberg, Matthias1
  • Hellmark, Thomas1
  • Höglund, Peter2
  • Clyne, Naomi1
  • 1 Lund University, Skåne University Hospital, Alwallhuset Barngatan 2A, Lund, 121 85, Sweden , Lund (Sweden)
  • 2 Lund University, Skåne University Hospital, Lund, Sweden , Lund (Sweden)
Published Article
BMC Nephrology
Springer (Biomed Central Ltd.)
Publication Date
Jun 22, 2020
DOI: 10.1186/s12882-020-01881-y
Springer Nature


BackgroundArteriosclerosis is prevalent in patients with chronic kidney disease (CKD). Our aims were to investigate (1) the effects of 12 months of either balance- or strength- both in combination with endurance training on abdominal aortic calcification (AAC); on some lipids and calcific- and inflammatory markers; and (2) the relationships between the change in AAC score and these markers in non-dialysis dependent patients with CKD stages 3 to 5.MethodsOne hundred twelve patients (mean age 67 ± 13 years), who completed 12 months of exercise training; comprising either balance- or strength training, both in combination with endurance training; with a measured glomerular filtration rate (mGFR) 22.6 ± 8 mL/min/1.73m2, were included in this study. AAC was evaluated with lateral lumbar X-ray using the scoring system described by Kauppila. Plasma fetuin-A, fibroblast growth factor 23 (FGF23) and interleukin 6 (IL6) were measured with Enzyme-linked immunosorbent assay (ELISA) kits.ResultsAfter 12 months of exercise training, the AAC score increased significantly in both groups; mGFR and lipoprotein (a) decreased significantly in both groups; parathyroid hormone (PTH) and 1,25(OH)2D3 increased significantly only in the strength group; fetuin-A increased significantly only in the balance group. Plasma triglycerides, total cholesterol, high-density lipoprotein cholesterol, low-density lipoprotein cholesterol, FGF23, phosphate, calcium, IL6, C-reactive protein (CRP), albumin were unchanged. The increase in AAC score was positively related to ageing and the levels of baseline triglycerides and lipoprotein (a).ConclusionsExercise training did not prevent the progression of AAC; it might have contributed to the reduced levels of lipoprotein (a) and unchanged levels of calcific- and inflammatory markers in these patients with non-dialysis dependent CKD. Hypertriglyceridemia, high levels of lipoprotein (a) and ageing emerged as longitudinal predictors of vascular calcification in these patients.Trial registrationNCT02041156 at Date of registration: January 20, 2014. Retrospectively registered.

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