Characterising skeletal muscle haemoglobin saturation during exercise using near-infrared spectroscopy in chronic kidney disease
| Autor: | Alice E. M. White, Emma L. Watson, Thomas J. Wilkinson, Douglas W. Gould, Alice C. Smith, Daniel G. D. Nixon |
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| Rok vydání: | 2018 |
| Předmět: |
Nephrology
Adult Male medicine.medical_specialty Anaerobic Threshold Physiology Oxygen saturation 030232 urology & nephrology 030204 cardiovascular system & hematology Incremental exercise 03 medical and health sciences chemistry.chemical_compound Hemoglobins 0302 clinical medicine Oxygen Consumption Full recovery Near-infrared spectroscopy Physiology (medical) Internal medicine Chronic kidney disease Medicine Humans Renal Insufficiency Chronic Muscle Skeletal Exercise Aged Spectroscopy Near-Infrared business.industry Myoglobin Haemoglobin saturation Skeletal muscle Middle Aged medicine.disease Healthy Volunteers medicine.anatomical_structure chemistry Diabetes Mellitus Type 2 Cardiology Exercise Test Female Original Article Haemoglobin business Kidney disease Glomerular Filtration Rate |
| Zdroj: | Clinical and Experimental Nephrology |
| ISSN: | 1437-7799 |
| Popis: | Background Chronic kidney disease (CKD) patients have reduced exercise capacity. Possible contributing factors may include impaired muscle O2 utilisation through reduced mitochondria number and/or function slowing the restoration of muscle ATP concentrations via oxidative phosphorylation. Using near-infrared spectroscopy (NIRS), we explored changes in skeletal muscle haemoglobin/myoglobin O2 saturation (SMO2%) during exercise. Methods 24 CKD patients [58.3 (± 16.5) years, eGFR 56.4 (± 22.3) ml/min/1.73 m2] completed the incremental shuttle walk test (ISWT) as a marker of exercise capacity. Using NIRS, SMO2% was measured continuously before, during, and after (recovery) exercise. Exploratory differences were investigated between exercise capacity tertiles in CKD, and compared with six healthy controls. Results We identified two discrete phases; a decline in SMO2% during incremental exercise, followed by rapid increase upon cessation (recovery). Compared to patients with low exercise capacity [distance walked during ISWT, 269.0 (± 35.9) m], patients with a higher exercise capacity [727.1 (± 38.1) m] took 45% longer to reach their minimum SMO2% (P = .038) and recovered (half-time recovery) 79% faster (P = .046). Compared to controls, CKD patients took significantly 56% longer to recover (i.e., restore SMO2% to baseline, full recovery) (P = .014). Conclusions Using NIRS, we have determined for the first time in CKD, that favourable SMO2% kinetics (slower deoxygenation rate, quicker recovery) are associated with greater exercise capacity. These dysfunctional kinetics may indicate reduced mitochondria capacity to perform oxidative phosphorylation—a process essential for carrying out even simple activities of daily living. Accordingly, NIRS may provide a simple, low cost, and non-invasive means to evaluate muscle O2 kinetics in CKD. |
| Databáze: | OpenAIRE |
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