Evidence map›Paper›PMID 34758473›Full record

ArticleKidney & blood pressure research2022

Renin-Angiotensin System Blockade Is Associated with Exercise Capacity, Sympathetic Activity, and Endothelial Function in Patients with Chronic Kidney Disease.

Jin Hee Jeong, Justin D Sprick, Dana DaCosta, Arshed A Quyyumi, Jeanie Park

Open access · goldAbstract read
In one paragraph

Article in Kidney & blood pressure research, 2022. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 2 papers.

0numbers the graph read from it
0cells of the map it votes in
2citing papers in PubMed
0.8field-weighted citation impact, top 25% of its field
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

2 citing papers in PubMed, 6 citations in OpenAlex.

  1. Article
  2. Neurocirculatory regulation and adaptations to exercise in chronic kidney disease.American journal of physiology. Heart and circulatory physiology · 2023
    Review
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

5 authors at 1 institution in 1 country.

Jin Hee JeongDivision of Renal Medicine, Department of Medicine, Emory University School of Medicine, Atlanta, Georgia, USA, jin.jeong@emory.edu.
Justin D SprickDivision of Renal Medicine, Department of Medicine, Emory University School of Medicine, Atlanta, Georgia, USA.
Dana DaCostaDivision of Renal Medicine, Department of Medicine, Emory University School of Medicine, Atlanta, Georgia, USA.
Arshed A QuyyumiDivision of Cardiology, Department of Medicine, Emory University School of Medicine, Atlanta, Georgia, USA.
Jeanie ParkDivision of Renal Medicine, Department of Medicine, Emory University School of Medicine, Atlanta, Georgia, USA.
Emory University · US

Funding

Neurovascular Regulation During Exercise In Humans With Chronic Kidney DiseaseR01HL135183 · NHLBI · EMORY UNIVERSITY · PI Jeanie Park · 2017 to 2026
$5.4M
Sympatho-inhibition with Mindfulness in Chronic Kidney DiseaseR33AT010457 · NCCIH · EMORY UNIVERSITY · PI PARK, JEANIE · 2022 to 2024
$2.0M
Sympatho-inhibition with Mindfulness in Chronic Kidney DiseaseR61AT010457 · NCCIH · EMORY UNIVERSITY · PI PARK, JEANIE · 2019 to 2020
$946k
Intramuscular Mechanisms Regulating Neurocirculatory Control in Chronic Kidney DiseaseF32HL147547 · NHLBI · EMORY UNIVERSITY · PI SPRICK, JUSTIN DANIEL · 2019 to 2021
$161k
Mechanisms of Sympathetic Overactivity in Post-traumatic Stress DisorderI01CX001065 · VA · VETERANS HEALTH ADMINISTRATION · PI PARK, JEANIE · 2015 to 2024
–
CSRD VA I01 CX001065NCCIH NIH HHS R33 AT010457NCCIH NIH HHS R61 AT010457NHLBI NIH HHS F32 HL147547NHLBI NIH HHS R01 HL135183
6 · The paper itself

Abstract

backgroundChronic kidney disease (CKD) patients have exercise intolerance and exaggerated blood pressure reactivity during exercise that are mediated by sympathetic nervous system (SNS) overactivation and decreased nitric oxide (NO) bioavailability. The activation of the renin-angiotensin system (RAS) increases SNS activation and reduces NO synthesis, and prior studies suggest that RAS blockade attenuates declines in physical function. We hypothesized that RAS inhibitor (RASi) use is associated with higher exercise capacity mediated by decreased SNS activity and increased NO-dependent endothelial function in CKD.

methodIn 35 CKD patients (57 ± 7 years) and 20 controls (CONs) (53 ± 8 years), we measured exercise capacity (peak oxygen consumption [VO2peak]), muscle sympathetic nervous activity (MSNA), and flow-mediated dilation (FMD) for NO-dependent endothelial function.

resultsCKD patients treated with RASi (CKD + RASi, n = 25) had greater VO2peak than CKD patients not treated with RASi (CKD no RASi, n = 10), but lower VO2peak than CONs (23.3 ± 5.8 vs. 16.4 ± 2.9, p = 0.007; vs. 30.0 ± 7.7, p = 0.016 mL/min/kg, respectively). CKD + RASi had lower resting MSNA and greater FMD than CKD no RASi. Compared to CONs, CKD + RASi had similar MSNA but lower FMD. VO2peak was positively associated with FMD (r = 0.417, p = 0.038) and was predicted by the combination of FMD and RASi status (r2 = 0.344, p = 0.01) and MSNA and RASi status (r2 = 0.575, p = 0.040) in CKD patients.

conclusionIn summary, CKD patients with RASi have higher exercise capacity than those not on RASi. Higher exercise capacity in the RASi-treated group was associated with lower resting SNS activity and higher NO-dependent vascular endothelial function.

Indexed as

Renal Insufficiency, ChronicRenin-Angiotensin SystemBlood PressureExercise ToleranceHumansSympathetic Nervous SystemChronic kidney diseaseEndothelial dysfunctionExercise capacityRenin-angiotensin systemSympathetic activity

Identifiers

PMID34758473
PMCPMC8844058
OpenAlexW3212588722

What OpenQuestion holds

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Registered trials

None linked

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.