Impact of cardiac rehabilitation on renal function in patients with and without chronic kidney disease after acute myocardial infarction

Yoichi Takaya, Reon Kumasaka, Tetsuo Arakawa, Takahiro Ohara, Michio Nakanishi, Teruo Noguchi, Masanobu Yanase, Hiroshi Takaki, Yuhei Kawano, Yoichi Goto

Research output: Contribution to journalArticle

20 Citations (Scopus)

Abstract

Background: Although there is a general fear that exercise training might deteriorate renal function in chronic kidney disease (CKD) patients, the effect of cardiac rehabilitation (CR) on renal function in acute myocardial infarction (AMI) patients with CKD remains unknown. We sought to determine whether CR is associated with amelioration or deterioration of renal function in such patients. Methods and Results: We enrolled 528 AMI patients who participated in a 3-month CR program. Clinical data before and after CR were compared according to participation in CR and comorbidities. In patients without CKD (estimated glomerular filtration rate [eGFR] ≥60ml•min-1•1.73m-2, n=348), peak oxygen uptake (VO2) and B-type natriuretic peptide (BNP) improved without a change in eGFR. In contrast, in patients with CKD (eGFR <60ml•min-1•1.73m-2, n=180), eGFR improved (48±12 to 53±15ml•min-1•1.73m-2, P<0.001), together with improvements in peak VO2 and BNP. When patients with CKD were divided into non-active (≤1time/week, n=70) and active participants (≥1.1time/week, n=110) according to attendance in CR, active participants showed an improvement in eGFR (50±10 to 53±13ml•min-1•1.73m-2, P<0.001), whereas eGFR did not change in non-active participants. Similar results were obtained in each subgroup of patients with hypertension, dyslipidemia, or diabetes mellitus. Conclusions: In AMI patients with CKD, active participation in CR was associated with improved peak VO2, BNP, and eGFR.

Original languageEnglish
Pages (from-to)377-384
Number of pages8
JournalCirculation Journal
Volume78
Issue number2
DOIs
Publication statusPublished - 2014
Externally publishedYes

Fingerprint

Chronic Renal Insufficiency
Glomerular Filtration Rate
Myocardial Infarction
Kidney
Brain Natriuretic Peptide
Cardiac Rehabilitation
Dyslipidemias
Fear
Comorbidity
Diabetes Mellitus
Exercise
Oxygen
Hypertension

Keywords

  • Acute myocardial infarction
  • Cardiac rehabilitation
  • Exercise training
  • Renal function

ASJC Scopus subject areas

  • Cardiology and Cardiovascular Medicine
  • Medicine(all)

Cite this

Impact of cardiac rehabilitation on renal function in patients with and without chronic kidney disease after acute myocardial infarction. / Takaya, Yoichi; Kumasaka, Reon; Arakawa, Tetsuo; Ohara, Takahiro; Nakanishi, Michio; Noguchi, Teruo; Yanase, Masanobu; Takaki, Hiroshi; Kawano, Yuhei; Goto, Yoichi.

In: Circulation Journal, Vol. 78, No. 2, 2014, p. 377-384.

Research output: Contribution to journalArticle

Takaya, Y, Kumasaka, R, Arakawa, T, Ohara, T, Nakanishi, M, Noguchi, T, Yanase, M, Takaki, H, Kawano, Y & Goto, Y 2014, 'Impact of cardiac rehabilitation on renal function in patients with and without chronic kidney disease after acute myocardial infarction', Circulation Journal, vol. 78, no. 2, pp. 377-384. https://doi.org/10.1253/circj.CJ-13-0779
Takaya, Yoichi ; Kumasaka, Reon ; Arakawa, Tetsuo ; Ohara, Takahiro ; Nakanishi, Michio ; Noguchi, Teruo ; Yanase, Masanobu ; Takaki, Hiroshi ; Kawano, Yuhei ; Goto, Yoichi. / Impact of cardiac rehabilitation on renal function in patients with and without chronic kidney disease after acute myocardial infarction. In: Circulation Journal. 2014 ; Vol. 78, No. 2. pp. 377-384.
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AU - Takaya, Yoichi

AU - Kumasaka, Reon

AU - Arakawa, Tetsuo

AU - Ohara, Takahiro

AU - Nakanishi, Michio

AU - Noguchi, Teruo

AU - Yanase, Masanobu

AU - Takaki, Hiroshi

AU - Kawano, Yuhei

AU - Goto, Yoichi

PY - 2014

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N2 - Background: Although there is a general fear that exercise training might deteriorate renal function in chronic kidney disease (CKD) patients, the effect of cardiac rehabilitation (CR) on renal function in acute myocardial infarction (AMI) patients with CKD remains unknown. We sought to determine whether CR is associated with amelioration or deterioration of renal function in such patients. Methods and Results: We enrolled 528 AMI patients who participated in a 3-month CR program. Clinical data before and after CR were compared according to participation in CR and comorbidities. In patients without CKD (estimated glomerular filtration rate [eGFR] ≥60ml•min-1•1.73m-2, n=348), peak oxygen uptake (VO2) and B-type natriuretic peptide (BNP) improved without a change in eGFR. In contrast, in patients with CKD (eGFR <60ml•min-1•1.73m-2, n=180), eGFR improved (48±12 to 53±15ml•min-1•1.73m-2, P<0.001), together with improvements in peak VO2 and BNP. When patients with CKD were divided into non-active (≤1time/week, n=70) and active participants (≥1.1time/week, n=110) according to attendance in CR, active participants showed an improvement in eGFR (50±10 to 53±13ml•min-1•1.73m-2, P<0.001), whereas eGFR did not change in non-active participants. Similar results were obtained in each subgroup of patients with hypertension, dyslipidemia, or diabetes mellitus. Conclusions: In AMI patients with CKD, active participation in CR was associated with improved peak VO2, BNP, and eGFR.

AB - Background: Although there is a general fear that exercise training might deteriorate renal function in chronic kidney disease (CKD) patients, the effect of cardiac rehabilitation (CR) on renal function in acute myocardial infarction (AMI) patients with CKD remains unknown. We sought to determine whether CR is associated with amelioration or deterioration of renal function in such patients. Methods and Results: We enrolled 528 AMI patients who participated in a 3-month CR program. Clinical data before and after CR were compared according to participation in CR and comorbidities. In patients without CKD (estimated glomerular filtration rate [eGFR] ≥60ml•min-1•1.73m-2, n=348), peak oxygen uptake (VO2) and B-type natriuretic peptide (BNP) improved without a change in eGFR. In contrast, in patients with CKD (eGFR <60ml•min-1•1.73m-2, n=180), eGFR improved (48±12 to 53±15ml•min-1•1.73m-2, P<0.001), together with improvements in peak VO2 and BNP. When patients with CKD were divided into non-active (≤1time/week, n=70) and active participants (≥1.1time/week, n=110) according to attendance in CR, active participants showed an improvement in eGFR (50±10 to 53±13ml•min-1•1.73m-2, P<0.001), whereas eGFR did not change in non-active participants. Similar results were obtained in each subgroup of patients with hypertension, dyslipidemia, or diabetes mellitus. Conclusions: In AMI patients with CKD, active participation in CR was associated with improved peak VO2, BNP, and eGFR.

KW - Acute myocardial infarction

KW - Cardiac rehabilitation

KW - Exercise training

KW - Renal function

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