Handgrip exercise training for chronic kidney disease

Neural and Vascular Modulation With Isometric Handgrip Training in Chronic Kidney Disease

This program will see if doing at-home handgrip exercises three times a week can lower resting and exercise blood pressure in people aged 45–85 with stage III–IV chronic kidney disease who don't exercise regularly.

Quick facts

• Phase: NA
• Study type: Interventional
• Enrollment: 50 (estimated)
• Ages: 45 Years to 85 Years
• Sex: All
• Sponsor: Emory University (other)
• Locations: 1 site (Atlanta, Georgia)
• Trial ID: NCT07094906 on ClinicalTrials.gov

What this trial studies

This interventional study will enroll about 50 adults with stage III–IV chronic kidney disease and randomize them to eight weeks of supervised home isometric handgrip exercise training or a sham training control. Participants will perform handgrip sessions three times per week (four 2-minute squeezes per hand) and attend seven in-person study visits over roughly 12 weeks for blood pressure measurements, exercise testing, blood draws, and vascular and autonomic function testing. The team will measure resting and exercise blood pressure, catecholamine levels, and vascular dilation to explore mechanisms of any blood pressure changes. Recruitment and visits occur through the Emory Healthcare system in Atlanta, Georgia.

Who should consider this trial

Good fit: Adults aged 45–85 with stage IIIa–IV CKD (eGFR 15–59 mL/min/1.73 m2), stable renal function, and who do not exercise regularly are ideal candidates.

Not a fit: People with severe kidney failure (eGFR <15 mL/min/1.73 m2), symptomatic heart failure or low ejection fraction, severe anemia, diabetic neuropathy, ongoing substance abuse, or those already exercising regularly are unlikely to benefit or be eligible.

Why it matters

Potential benefit: If successful, this could offer a simple, low-cost home-based exercise that helps lower blood pressure and may reduce cardiovascular risk in people with CKD.

How similar studies have performed: Isometric handgrip training has shown blood-pressure–lowering effects in prior general-population studies and is recommended by the American Heart Association, but it has been little tested specifically in CKD patients.

Eligibility criteria

Inclusion Criteria:

* Patients with CKD (Stages IIIa and IV),
* Ages 45-85 years who do not regularly exercise (defined as exercising less than 20 minutes twice per week), willing and able to cooperate with the protocol.
* CKD Stages III and IV will be defined as reduction in estimated glomerular filtration rate (eGFR) to 15-59 cc/minute as calculated by the modified CKD-EPI equations.
* Patients with CKD must have stable renal function (no greater than a 20% reduction in eGFR over the prior 3 months).

Exclusion Criteria:

* Severe CKD (eGFR\<15 cc/minute)
* Metabolic alkalosis (serum bicarbonate \> 28 meq/L)
* Ongoing drug or alcohol abuse
* Diabetic neuropathy
* Any serious systemic disease that might influence survival
* Severe anemia with hgb level \<10 g/dL
* Clinical evidence of congestive heart failure or ejection fraction below 35%, symptomatic heart disease determined by prior electrocardiogram, stress test, and/or history, treatment with central alpha agonists (clonidine)
* Uncontrolled hypertension with BP greater than 170/100 mm Hg
* Low blood pressure with BP less than 100/50
* Pregnancy or plans to become pregnant
* Current treatment with MAO inhibitors
* Inability to perform handgrip exercise

Where this trial is running

Atlanta, Georgia

• Emory University — Atlanta, Georgia, United States (RECRUITING)

Study contacts

• Principal investigator: Jeanie Park, MD — Emory University
• Study coordinator: Jeanie Park, MD

Conditions: Chronic Kidney Diseases, Handgrip, Isometric handgrip exercise training, Blood pressure variability