Determinants of V̇O(2peak) in patients with end-stage renal disease: On and off dialysis

G. E. Moore, K. R. Brinker, J. Stray-Gundersen, J. H. Mitchell

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Abstract

Peak oxygen uptake (V̇O(2peak)) of patients on maintenance hemodialysis is very low. Exercise training performed during, or 'on' dialysis, and at other times, 'off' dialysis, both improve V̇O(2peak). Equivalence of these approaches has not been shown, nor have the physiologic factors limiting V̇O(2peak) been clarified in these patients. We hypothesized that hemodialysis does not acutely alter the cardiovascular response to peak exercise, and further that anemia and a low peak heart rate limit V̇O(2peak). Ten patients with end-stage renal disease (ESRD) performed cycle ergometry to peak exercise. Peak oxygen uptake measured immediately prior to dialysis was compared with predicted values, and with measurements obtained during the second 30 min of dialysis. The determinants of V̇O(2peak) were compared with previously reported norms. 'Off' dialysis, V̇O(2peak) for nine of 10 patients was below the 95% confidence limit for normals. Their cardiovascular response to peak exercise was unchanged by 30-60 min of hemodialysis. Stroke volume was similar to that of normals; however, peak heart rate was 77% of predicted, and hematocrit was 27% (at rest). Peak exercise mixed-venous oxygen content was 3.6 ml O2 ml·dl-1 blood, similar to values reported for athletes. These findings show that up to 1 h of dialysis minimally effects V̇O(2peak), and imply that low oxygen delivery limited V̇O(2peak) in these patients.

Original languageEnglish (US)
Pages (from-to)18-23
Number of pages6
JournalMedicine and Science in Sports and Exercise
Volume25
Issue number1
DOIs
StatePublished - 1993

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Chronic Kidney Failure
Dialysis
Exercise
Oxygen
Renal Dialysis
Heart Rate
Ergometry
Hematocrit
Athletes
Stroke Volume
Anemia
Maintenance

Keywords

  • AEROBIC
  • CARDIOVASCULAR
  • EXERCISE
  • HEMODIALYSIS

ASJC Scopus subject areas

  • Public Health, Environmental and Occupational Health
  • Physical Therapy, Sports Therapy and Rehabilitation
  • Orthopedics and Sports Medicine

Cite this

Determinants of V̇O(2peak) in patients with end-stage renal disease : On and off dialysis. / Moore, G. E.; Brinker, K. R.; Stray-Gundersen, J.; Mitchell, J. H.

In: Medicine and Science in Sports and Exercise, Vol. 25, No. 1, 1993, p. 18-23.

Research output: Contribution to journalArticle

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