Evidence map›Paper›PMID 30566512›Full record

ArticlePloS one2018

Gradual reduction in exercise capacity in chronic kidney disease is associated with systemic oxygen delivery factors.

Helena Wallin, Anna M Asp, Carin Wallquist, Eva Jansson, Kenneth Caidahl, Britta Hylander Rössner, Stefan H Jacobson, Anette Rickenlund, Maria J Eriksson

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Article in PloS one, 2018. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 24 papers, 2 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
24citing papers in PubMed, 2 pooled it
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

24 citing papers in PubMed, 2 syntheses or guidelines pooled it.

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  16. Neurocirculatory regulation and adaptations to exercise in chronic kidney disease.American journal of physiology. Heart and circulatory physiology · 2023
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4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

9 authors.

Helena WallinDepartment of Laboratory Medicine, Division of Clinical Physiology, Karolinska Institutet, Stockholm, Sweden.ORCID 0000-0001-9187-2426
Anna M AspDepartment of Clinical Physiology, Karolinska University Hospital, Stockholm, Sweden.
Carin WallquistDepartment of Nephrology, Karolinska University Hospital, Karolinska Institutet, Stockholm, Sweden.
Eva JanssonDepartment of Laboratory Medicine, Division of Clinical Physiology, Karolinska Institutet, Stockholm, Sweden.
Kenneth CaidahlDepartment of Clinical Physiology, Karolinska University Hospital, Stockholm, Sweden.
Britta Hylander RössnerDepartment of Nephrology, Karolinska University Hospital, Karolinska Institutet, Stockholm, Sweden.ORCID 0000-0001-9053-4409
Stefan H JacobsonDivision of Nephrology, Department of Clinical Sciences, Karolinska Institutet Danderyd University Hospital, Stockholm, Sweden.
Anette RickenlundDepartment of Laboratory Medicine, Division of Clinical Physiology, Karolinska Institutet, Stockholm, Sweden.
Maria J ErikssonDepartment of Clinical Physiology, Karolinska University Hospital, Stockholm, Sweden.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundThe cause of reduced exercise capacity (ExCap) in chronic kidney disease (CKD) is multifactorial. The aim of this study was to investigate determinants of aerobic ExCap in patients with mild to severe CKD not undergoing dialysis.

methodsWe included 52 individuals with CKD stage 2-3, 47 with stage 4-5, and 54 healthy controls. Peak workload and peak heart rate (HR) were assessed by a maximal cycle exercise test. Cardiac function including stroke volume (SV) and vascular stiffness were evaluated by ultrasound at rest. Handgrip strength, body composition, haemoglobin level and self-reported physical activity were assessed.

resultsPeak workload (221±60, 185±59, 150±54 W for controls, CKD 2-3 and CKD 4-5 respectively), peak HR (177±11, 161±24, 144±31 beats/min) and haemoglobin level (14.2±1.2, 13.5±1.4, 12.2±1.3 g/dL) were all three significantly lower in CKD 2-3 than in controls, (p = 0.001, 0.001 and 0.03 respectively) and were even lower in stages 4-5 CKD than in CKD 2-3 (p = 0.01, 0.001 and <0.001 respectively). Resting SV and lean body mass did not differ between groups and handgrip strength was significantly lower only in CKD 4-5 compared to controls (p = 0.02). Peak workload was strongly associated with the systemic oxygen delivery factors: SV, peak HR and haemoglobin level. These three factors along with age, sex and height2 explained 82% of variation in peak workload. Peak HR contributed most to the variation; the peripheral variables handgrip strength and vascular stiffness did not improve the explanatory value in regression analysis.

conclusionsIn this cross-sectional study of CKD patients not on dialysis, aerobic ExCap decreased gradually with disease severity. ExCap was associated mainly with systemic oxygen delivery factors, in particular peak HR. Neither muscle function and mass, nor vascular stiffness were independent determinants of aerobic ExCap in this group of CKD patients.

Indexed as

Body CompositionCross-Sectional StudiesDisease ProgressionExerciseExercise ToleranceFemaleHand StrengthHeart RateHemoglobinsHumansMaleMiddle AgedOxygenProspective StudiesRenal Insufficiency, ChronicSeverity of Illness IndexHemoglobinsOxygen

Identifiers

PMID30566512
PMCPMC6300328

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.