The role of deconditioning in the end-stage renal disease myopathy: physical exercise improves altered resting muscle oxygen consumption

Am J Nephrol. 2015;41(4-5):329-36. doi: 10.1159/000431339. Epub 2015 Jun 11.


Background: Skeletal muscle dysfunction and poor exercise tolerance are hallmarks of end-stage renal disease (ESRD). Noninvasively measured (near-infrared spectroscopy, NIRS) resting muscle oxygen consumption (rmVO2) is a biomarker of muscle dysfunction, which can be applied to study the severity and the reversibility of ESRD myopathy. We tested the hypothesis that deconditioning is a relevant factor in ESRD myopathy.

Methods: The whole dialysis population (n = 59) of two of the eight centers participating into the EXCITE study ( NCT01255969), a randomized trial evaluating the effect of a home-based exercise program on the functional capacity of these patients was studied. Thirty-one patients were in the active arm (exercise group) and 28 in the control arm (no intervention). Normative data for rmVO2 were obtained from a group of 19 healthy subjects.

Results: rmVO2 was twice higher (p < 0.001) in ESRDs patients (0.083 ± 0.034 ml/100 g/min) than in healthy subjects (0.041 ± 0.020 ml/100 g/min) indicating substantial skeletal muscle dysfunction in ESRD. rmVO2 correlated with resting heart rate (r = 0.34, p = 0.009) but was independent of age, dialysis vintage, biochemical, vascular and nutrition parameters. After the 6-month exercise program, rmVO2 reduced to 0.064 ± 0.024 ml/100 g/min (-23%, p < 0.001) in the exercise group indicating that skeletal muscle dysfunction is largely reversible but remained identical in the control group (0.082 ± 0.032 to 0.082 ± 0.031 ml/100 g/min).

Conclusion: Deconditioning has a major role in ESRD myopathy. rmVO2 is a marker of physical deconditioning and has the potential for monitoring re-conditioning programs based on physical exercise in the ESRD population.

Publication types

  • Randomized Controlled Trial
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Aged
  • Aged, 80 and over
  • Cardiovascular Deconditioning*
  • Exercise
  • Exercise Test
  • Exercise Therapy*
  • Exercise Tolerance
  • Female
  • Heart Rate
  • Humans
  • Kidney Failure, Chronic / complications
  • Kidney Failure, Chronic / therapy*
  • Male
  • Middle Aged
  • Muscle, Skeletal / metabolism*
  • Muscular Diseases / etiology
  • Muscular Diseases / therapy*
  • Oxygen Consumption*
  • Physical Fitness
  • Renal Dialysis*
  • Spectroscopy, Near-Infrared
  • Treatment Outcome

Associated data